Active NPI
D. Jason Eklund, D.M.D. P.A.
- General Practice Dentistry
- Pearl, MS
National Provider Identifier
1003002320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 267192
- Practice address
- 2701 Old Brandon Rd
Pearl, MS 39208-4702 - Phone
- (601) 939-3561
- Fax
- (601) 939-3583
- NPI assigned
- Sep 20, 2007
- 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 | 267192 | MS | Primary |
Addresses
Primary practice location
2701 Old Brandon Rd
Pearl, MS 39208-4702
Mailing address
2701 Old Brandon Rd
Pearl, MS 39208-4702
Phone (601) 939-3561
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 267192 | MS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1003002320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 OLD BRANDON RD",
"city": "PEARL",
"state": "MS",
"postal_code": "392084702",
"telephone_number": "601-939-3561",
"fax_number": "601-939-3583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 OLD BRANDON RD",
"city": "PEARL",
"state": "MS",
"postal_code": "392084702",
"telephone_number": "601-939-3561",
"fax_number": "601-939-3583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EKLUND",
"first_name": "D.",
"middle_name": "JASON",
"credential": "D.M.D. P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-20",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "267192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearl, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.