Organization Active NPI

Family Dental Care

  • Dentist
  • Magee, MS
National Provider Identifier
1801128129
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2692-92 Issued in MS
Legal business name
FAMILY DENTAL CARE
Practice address
203 Main Ave N
Magee, MS 39111
Phone
(601) 849-6871
Fax
(601) 849-5257
NPI assigned
Feb 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Russell H Slover, DMD
Title
Owner
Phone
(601) 849-6871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2692-92 MS Primary

Addresses

Primary practice location

203 Main Ave N
Magee, MS 39111

Mailing address

203 Main Ave N
Magee, MS 39111-3535
Phone (601) 849-6871

Other identifiers 1

IdentifierTypeStateIssuer
00660036MedicaidMS

National Provider Directory

National Provider Directory

Locations

203 Main Ave N
Magee, MS 39111
Phone (601) 849-6871

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1801128129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MAIN AVE N",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391113535",
            "telephone_number": "601-849-6871",
            "fax_number": "601-849-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MAIN AVE N",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "39111",
            "telephone_number": "601-849-6871",
            "fax_number": "601-849-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "SLOVER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-849-6871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "2692-92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660036",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Magee, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.