Organization Active NPI

Mississippi Dentistry for Children, Inc

  • Pediatric Dentistry
  • McComb, MS
National Provider Identifier
1023290012
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
MISSISSIPPI DENTISTRY FOR CHILDREN, INC
Practice address
1071 Highway 51 and 98
McComb, MS 39648-8712
Phone
(601) 250-4115
Fax
(601) 250-4116
NPI assigned
Nov 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Valerie J TurnerNPI 1972527034
Title
Doctor/Owner
Phone
(601) 250-4115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1071 Highway 51 and 98
McComb, MS 39648-8712

Mailing address

1071 Highway 51 and 98
McComb, MS 39648-8712
Phone (601) 250-4115

Other identifiers 1

IdentifierTypeStateIssuer
06708221MedicaidMS

National Provider Directory

National Provider Directory

Locations

1071 Highway 51 and 98
McComb, MS 39648
Phone (601) 250-4115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1023290012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 HIGHWAY 51 AND 98",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396488712",
            "telephone_number": "601-250-4115",
            "fax_number": "601-250-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 HIGHWAY 51 AND 98",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396488712",
            "telephone_number": "601-250-4115",
            "fax_number": "601-250-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI DENTISTRY FOR CHILDREN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "601-250-4115"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06708221",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.