Pediatric Dentistry, P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

1865-80 Issued in MS

Legal business name

PEDIATRIC DENTISTRY, P.A.

Practice address

5315 Highway 18 W
Jackson, MS 39209-9421

Phone

(601) 922-0066

Fax

(601) 922-0077

NPI assigned

Jun 13, 2011

Organization subpart

No

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

Authorized official

Name

Dr. L Lee Cope, D.D.S.

Title

Dentist

Phone

(601) 922-0066

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Susan Cope Fortenberry, D.M.D.

  • Pediatric Dentistry
  • Jackson, MS
  • NPI 1083936132
  NPD (past)
• Martha Mangum Holland, D.M.D.

  • Pediatric Dentistry
  • Jackson, MS
  • NPI 1316322233
  NPD (past)

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1134414733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 HIGHWAY 18 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392099421",
            "telephone_number": "601-922-0066",
            "fax_number": "601-922-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 HIGHWAY 18 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392099421",
            "telephone_number": "601-922-0066",
            "fax_number": "601-922-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "COPE",
        "authorized_official_first_name": "L",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "601-922-0066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "1865-80",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00064746",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Peavie, CFNP
• Collier Peavy, FNP-C
• Ashley Elizabeth Peden, NP
• Randall Ashley Peden, FNP-C
• Glenn A Pederson
• Pediatric Orthopaedic Specialists of Mississippi
• Jonathan R Peeden, PHARM.D.
• Chere Hunter Peel, M.D.
• Holly Peeples, M.D.
• Samuel H Peeples, M.D.

• Pediatric Dentistry in Jackson, MS
• Providers in Jackson, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.