Todd Dixon Family Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TODD DIXON FAMILY DENTISTRY LLC

Practice address

26 Parkway Blvd
Hattiesburg, MS 39401-8879

Phone

(601) 583-6613

Fax

(601) 583-9832

NPI assigned

Aug 26, 2019

Organization subpart

No

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

Authorized official

Name

Stephen Todd Dixon, DMD

Title

Dentist

Phone

(601) 583-6613

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1003463845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 PARKWAY BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018879",
            "telephone_number": "601-583-6613",
            "fax_number": "601-583-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 PARKWAY BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018879",
            "telephone_number": "601-583-6613",
            "fax_number": "601-583-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD DIXON FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "601-583-6613",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660391",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tillery Dental Clinic
• Ariell Brianna Tillman
• Timothy M. Wiebe
• Rahul Reddy Tirumalareddy, MD
• Gregory R Toczyl, MD
• Bradley Tolar, DNP, CRNA
• Melissa Ruth Tolar, FNP
• Natalie Kate Tolar, FNP
• William E. Tolbert, DDS
• Donna Dimarco Tomlinson, FNP

• Dental Clinic/Center in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.