Denessa V Potts, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

3314-04 Issued in MS

Practice address

1668 W Peace St
Canton, MS 39046-5332

Phone

(601) 859-5213

Fax

(601) 859-9477

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Denessa V Toombs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advance Dental Clinic

  • Dentist
  • Jackson, MS
  • NPI 1073708913
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1154401172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465332",
            "telephone_number": "601-859-5213",
            "fax_number": "601-859-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465332",
            "telephone_number": "601-859-5213",
            "fax_number": "601-859-9477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 E County Line Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392111801",
            "country_code": "US",
            "telephone_number": "601-206-1112",
            "fax_number": "601-206-1114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTS",
        "first_name": "DENESSA",
        "middle_name": "V",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3314-04",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03588521",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENESSA",
            "last_name": "TOOMBS",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Canton, MS
• Providers in Canton, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.