Organization Active NPI

Camille Sandifer, DMD, MSD Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jackson, MS
National Provider Identifier
1134569981
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
OR-458-12 Issued in MS
Legal business name
CAMILLE SANDIFER, DMD, MSD INC
Practice address
4500 I 55 N
Highland Village #247
Jackson, MS 39211-5930
Phone
(601) 981-5004
Fax
(601) 981-0501
NPI assigned
Jun 25, 2013
Last updated
Jun 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Authorized official

Name
Dr. Lyndsey Camille Sandifer, DMD, MSD
Title
President/Doctor
Phone
(601) 981-5004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X OR-458-12 MS Primary

Addresses

Primary practice location

4500 I 55 N
Highland Village #247
Jackson, MS 39211-5930

Mailing address

4500 I 55 N
Highland Village #247
Jackson, MS 39211-5930
Phone (601) 981-5004

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1134569981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 I 55 N",
            "address_2": "HIGHLAND VILLAGE #247",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115930",
            "telephone_number": "601-981-5004",
            "fax_number": "601-981-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 I 55 N",
            "address_2": "HIGHLAND VILLAGE #247",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115930",
            "telephone_number": "601-981-5004",
            "fax_number": "601-981-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMILLE SANDIFER, DMD, MSD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "SANDIFER",
        "authorized_official_first_name": "LYNDSEY",
        "authorized_official_middle_name": "CAMILLE",
        "authorized_official_title_or_position": "PRESIDENT/DOCTOR",
        "authorized_official_telephone_number": "601-981-5004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MS",
            "license": "OR-458-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.