Organization Active NPI

Epp Lowery Ms PLLC

  • Endodontics
  • Southaven, MS
National Provider Identifier
1164245312
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
EPP LOWERY MS PLLC
Practice address
5740 Getwell Rd BLDG 10a
Southaven, MS 38672-7360
Phone
(662) 890-3196
NPI assigned
Nov 6, 2024
Last updated
Nov 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Authorized official

Name
Jason Bertollini
Title
Credentialing Manager
Phone
(315) 450-0763

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X Primary

Addresses

Primary practice location

5740 Getwell Rd BLDG 10a
Southaven, MS 38672-7360

Mailing address

PO Box 1584
Brentwood, TN 37024-1584
Phone (315) 450-0763

National Provider Directory

National Provider Directory

Locations

5740 Getwell Rd
Bldg 10A
Southaven, MS 38672
Phone (662) 890-3196

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": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1164245312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1584",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370241584",
            "telephone_number": "315-450-0763",
            "fax_number": "615-422-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 GETWELL RD BLDG 10A",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386727360",
            "telephone_number": "662-890-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPP LOWERY MS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "BERTOLLINI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "315-450-0763"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.