NPIMap

Organization Active NPI

Dr Daniel J Patti D.M.D., PA

  • Dentist
  • Brookhaven, MS
National Provider Identifier
1205138708
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DR DANIEL J PATTI D.M.D., PA
Practice address
439 North Jackson St.
Suite E
Brookhaven, MS 39601-2912
Phone
(601) 833-0777
Fax
(601) 833-6606
NPI assigned
Dec 3, 2010
Last updated
Dec 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Dr. Daniel J Patti, D.M.D.NPI 1275629164
Title
Owner
Phone
(601) 833-0777

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary
General Practice Dentistry 1223G0001X

Addresses

Primary practice location

439 North Jackson St.
Suite E
Brookhaven, MS 39601-2912

Mailing address

439 North Jackson St.
Suite E
Brookhaven, MS 39601-2912
Phone (601) 833-0777

Other identifiers 1

IdentifierTypeStateIssuer
07831757MedicaidMS

National Provider Directory

National Provider Directory

Locations

439 N Jackson St
Ste E
Brookhaven, MS 39601
Phone (601) 833-0777

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": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1205138708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 NORTH JACKSON ST.",
            "address_2": "SUITE E",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012912",
            "telephone_number": "601-833-0777",
            "fax_number": "601-833-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 NORTH JACKSON ST.",
            "address_2": "SUITE E",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012912",
            "telephone_number": "601-833-0777",
            "fax_number": "601-833-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DANIEL J PATTI D.M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "PATTI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-833-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07831757",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.