Individual provider Active NPI

Jeffrey Michael Niolet, D.M.D.

  • General Practice Dentistry
  • Long Beach, MS
National Provider Identifier
1245332303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3144-00 Issued in MS
Practice address
300 E Railroad St
Long Beach, MS 39560-4722
Phone
(228) 864-8711
Fax
(228) 864-3765
NPI assigned
Sep 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3144-00 MS Primary

Addresses

Primary practice location

300 E Railroad St
Long Beach, MS 39560-4722

Mailing address

300 E Railroad St
Long Beach, MS 39560-4722
Phone (228) 864-8711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220528000056 MS Practitioner - Dentist 8325337181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3144-00MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey M. Niolet, D.M.D. CurrentSince May 9, 2022 Accepting new patients

Locations

300 E Railroad St
Long Beach, MS 39560
Phone (228) 864-8711

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245332303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E RAILROAD ST",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604722",
            "telephone_number": "228-864-8711",
            "fax_number": "228-864-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E RAILROAD ST",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395604722",
            "telephone_number": "228-864-8711",
            "fax_number": "228-864-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIOLET",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3144-00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, MS

Sources for this page

Verify at the official NPI Registry.