Humphreys Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3329-05 Issued in MS

Legal business name

HUMPHREYS DENTAL, LLC

Practice address

444 Shelby Speights Drive
Purvis, MS 39475

Phone

(601) 794-8115

Fax

(601) 794-8115

NPI assigned

Oct 7, 2009

Last updated

Oct 7, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Chandler Humphreys, DMD

Title

Owner

Phone

(601) 794-8115

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254873600000",
    "number": "1104151265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 SHELBY SPEIGHTS DRIVE",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "39475",
            "telephone_number": "601-794-8115",
            "fax_number": "601-794-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 SHELBY SPEIGHTS DRIVE",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "39475",
            "telephone_number": "601-794-8115",
            "fax_number": "601-794-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMPHREYS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-07",
        "last_updated": "2009-10-07",
        "status": "A",
        "authorized_official_last_name": "HUMPHREYS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHANDLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-794-8115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3329-05",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hattiesburg Clinic PA (The Family Clinic - Purvis)
• Hattiesburg Clinic PA (Purvis Family Practice Clinic)
• Soraida Herring, CAT
• Sommer E Holloway, CMHT
• Kaliyah Hughes
• I-Chart LLC
• McKenzie Irish, PCMHT
• Elizabeth Jackson, LPC
• Josalin Jackson, R N
• James W. Moore, III

• General Practice Dentistry in Purvis, MS
• Providers in Purvis, 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 Oct 7, 2009; 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.