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CATHERINE JOHNSON MINCY DDS NPI 1790801298


NPI Information

NPI: 1790801298
Provider Name: CATHERINE JOHNSON MINCY, DDS

Former Legal Business Name: CATHERINE JOHNSON MINCY, DDS

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
607 W CHURCH ST
BOONEVILLE, MS
ZIP 38829
Phone: (662) 728-8133
Get Directions

CATHERINE JOHNSON MINCY, DDS is a general practice dentist in Booneville, MS. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CATHERINE JOHNSON MINCY, DDS NPI is 1790801298. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Catherine Johnson Mincy, Dds.

The provider's business location address is:

607 W CHURCH ST
BOONEVILLE, MS
ZIP 38829-647
Phone: (662) 728-8133
Fax: (662) 728-6903

The provider's authorized official is Catherine Johnson Mincy .
The authorized official title is Owner and has the following contact phone number (662) 728-8133.

The enumeration date for this NPI number is 3/22/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice3009-97MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100660215MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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