NPIMap

Organization Active NPI

Escatawpa Family Dentistry, LLC

  • General Practice Dentistry
  • Escatawpa, MS
National Provider Identifier
1134601156
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ESCATAWPA FAMILY DENTISTRY, LLC
Practice address
8016 Highway 613
Escatawpa, MS 39552
Phone
(228) 474-1314
NPI assigned
Sep 6, 2018
Last updated
Sep 6, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Authorized official

Name
Dr. Jeremy Parker, DMDNPI 1265744510
Title
Owner
Phone
(228) 392-0509

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
General Practice Dentistry 1223G0001X MS Primary

Addresses

Primary practice location

8016 Highway 613
Escatawpa, MS 39552

Mailing address

8016 Highway 613
Moss Point, MS 39562-8200
Phone (228) 474-1314

National Provider Directory

National Provider Directory

Locations

8016 Highway 613
Moss Point, MS 39562

Practitioners & affiliated clinicians

Practitioners 2

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": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1134601156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8016 HIGHWAY 613",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395628200",
            "telephone_number": "228-474-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8016 HIGHWAY 613",
            "city": "ESCATAWPA",
            "state": "MS",
            "postal_code": "39552",
            "telephone_number": "228-474-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESCATAWPA FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-392-0509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escatawpa, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.