Taylorsville Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TAYLORSVILLE FAMILY DENTAL

Practice address

411 Willis St
Taylorsville, MS 39168-4550

Phone

(601) 340-9457

NPI assigned

Aug 10, 2022

Organization subpart

No

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

Authorized official

Name

Kelly Miller

Title

Credentialing Specialist

Phone

(601) 271-8710

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1013645746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WILLIS ST",
            "city": "TAYLORSVILLE",
            "state": "MS",
            "postal_code": "391684550",
            "telephone_number": "601-340-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WILLIS ST",
            "city": "TAYLORSVILLE",
            "state": "MS",
            "postal_code": "391684550",
            "telephone_number": "601-340-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLORSVILLE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "601-271-8710"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon L Scruggs, FNP-BC
• Jo Ellen Sullivan, R. PH.
• T & H Healthcare Solutions, LLC
• T & T Nemt Services, LLP
• Taylorsville Eye Care LLC
• Sherry Thigpen, LPN
• Jennifer Thompson, PHARMD
• Nellie Turner
• Lamarca Marie Walker, TRANSPORTATION
• Diane Wyatt

• Dental Clinic/Center in Taylorsville, MS
• Providers in Taylorsville, 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 Aug 10, 2022; 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.