Active NPI
Mitchell Morris Guess, D.M.D
- General Practice Dentistry
- Hattiesburg, MS
National Provider Identifier
1013123421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2177-85
- Practice address
- 68 King Rd
Hattiesburg, MS 39402-9527 - Phone
- (601) 264-7112
- NPI assigned
- May 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 2177-85 | MS | Primary |
Addresses
Primary practice location
68 King Rd
Hattiesburg, MS 39402-9527
Mailing address
909 Elks Lake Rd
Hattiesburg, MS 39401-0334
Phone (601) 583-6747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6-0137 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150120002496 | MS | Order and Referring Only - Dentist | 4789908880 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2177-85 | MS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243900800000",
"number": "1013123421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 ELKS LAKE RD",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394010334",
"telephone_number": "601-583-6747",
"fax_number": "601-264-7495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 KING RD",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394029527",
"telephone_number": "601-264-7112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUESS",
"first_name": "MITCHELL",
"middle_name": "MORRIS",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2009-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "2177-85",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6-0137",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
- Phyllis A Grinstead, PCMHT
- Grove Transportation Company of Mississippi LLC
- Guardian Angels Home Care LLC
- Guardian Angels Home Care LLC
- Guardian Angels Hospice & Palliative Care LLC
- Carter Kenneth Derrick Guice III
- Charles Edwin Guice III, MD
- John M Guice, MD
- Guiding Light Services, LLC
- Scott P Guidry, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.