Humana Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HUMANA DENTAL CORPORATION

Practice address

4801 Cuba Millington Rd
Millington, TN 38053-5401

Phone

(318) 617-8665

Fax

(479) 252-6029

NPI assigned

Jan 26, 2007

Last updated

Feb 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steve R Alexander

Title

Director of Operations

Phone

(318) 617-8665

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Marascalco Skidmore, DDS

  • General Practice Dentistry
  • Millington, TN
  • NPI 1730235268
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1962558403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1415",
            "city": "GREENWOOD",
            "state": "AR",
            "postal_code": "729361415",
            "telephone_number": "318-617-8665",
            "fax_number": "479-252-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 CUBA MILLINGTON RD",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380535401",
            "telephone_number": "318-617-8665",
            "fax_number": "479-252-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMANA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "318-617-8665"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Millington, TN
• Providers in Millington, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.