Big River Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3125-00 Issued in MS

Legal business name

BIG RIVER DENTAL PLLC

Practice address

103 Christian Dr
Brandon, MS 39042-2762

Phone

(601) 825-1172

Fax

(601) 825-1185

NPI assigned

Jan 21, 2017

Last updated

Jan 21, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Percy Dickey III, DMD

Title

Owner/Partner

Phone

(601) 597-3490

Specialties & licenses 1

Addresses

Other names 1

• Magnolia Dental PLLC Former legal business name

Locations

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

{
    "created_epoch": "1484956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484956800000",
    "number": "1194262709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CHRISTIAN DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422762",
            "telephone_number": "601-825-1172",
            "fax_number": "601-825-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CHRISTIAN DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422762",
            "telephone_number": "601-825-1172",
            "fax_number": "601-825-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG RIVER DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-21",
        "last_updated": "2017-01-21",
        "status": "A",
        "authorized_official_last_name": "DICKEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PERCY",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "601-597-3490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3125-00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Dental PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Erica L Bertschler, NP
• Tomeka Lafawn Bethea
• Ava Bibbs
• Sara Biddle, MA MFFT
• Amy Bieski, CCC-SLP
• Shelly Ann Bilbro, NP
• Lakesha Lashaun Binder
• Bio-Medical Applications of Mississippi, Inc. (FMC Dialysis Services of Rankin County)
• Biogenics, LLC
• Deanna Bishop, PMHNP-BC, LPC

• General Practice Dentistry in Brandon, MS
• Providers in Brandon, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2017; 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.