Ralph Joseph Landry, DDD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MS2183-85 Issued in MS

Practice address

512 1St St
Clarksdale, MS 38614-4410

Phone

(662) 624-8114

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1063503126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 1ST ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144410",
            "telephone_number": "662-624-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 1ST ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144410",
            "telephone_number": "662-624-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "RALPH",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "MS2183-85",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2181-85",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00060140",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kikis
• Odessa L King, MSW
• Sonya Kinnard
• Emmanuel Kpabitey, M.D.
• Kroger Limited Partnership I
• Elizabeth Robertson Laney, AU.D.
• Celia C Lavender, M.S., CCC-SLP
• Chester L. Layne, D.D.S.
• Pertrice Lee, M.ED.
• Lucius Lewis Jr., CRNA

• General Practice Dentistry in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.

Verify at the official NPI Registry.