Active NPI
Alvin Wayne Rembert, DMD
- General Practice Dentistry
- Jackson, MS
National Provider Identifier
1851452080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2032-83
- Practice address
- 1500 East Woodrow Wilson Drive
Jackson, MS 39216 - Phone
- (601) 362-4471
- Fax
- (601) 368-3898
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2032-83 | MS | Primary |
Addresses
Primary practice location
1500 East Woodrow Wilson Drive
Jackson, MS 39216
Mailing address
803-Rutherford Drive
Jackson, MS 39206
Phone (601) 982-3570
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2032-83 | MS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851452080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803-RUTHERFORD DRIVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "39206",
"telephone_number": "601-982-3570",
"fax_number": "601-682-3570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 EAST WOODROW WILSON DRIVE",
"city": "JACKSON",
"state": "MS",
"postal_code": "39216",
"telephone_number": "601-362-4471",
"fax_number": "601-368-3898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REMBERT",
"first_name": "ALVIN",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "2032-83",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.