Active NPI
Family Dental Care
- Dentist
- Magee, MS
National Provider Identifier
1801128129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2692-92
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00660036 | Medicaid | MS |
National Provider Directory
National Provider DirectoryLocations
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.