Individual provider Active NPI

Samuel Hugh McLaurin Jr., DMD

  • Dentist
  • Bay Springs, MS
National Provider Identifier
1265562268
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2880-95 Issued in MS
Practice address
10 S Sixth St
Bay Springs, MS 39422-9055
Phone
(601) 764-4111
Fax
(601) 764-3443
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 288095 MO
Dentist 122300000X 2880-95 MS Primary

Addresses

Primary practice location

10 S Sixth St
Bay Springs, MS 39422-9055

Mailing address

PO Box 92
Bay Springs, MS 39422-0092
Phone (601) 764-4111

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
I20141126000982 MS Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042532129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2880-95MSMDDentist
288095MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
McLaurin Dental Clinic, P.a. General Practice CurrentSince Aug 2, 2022 Accepting new patients

Locations

12 S Sixth St
Bay Springs, MS 39422
Phone (601) 764-4111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1265562268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394220092",
            "telephone_number": "601-764-4111",
            "fax_number": "601-764-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S SIXTH ST",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394229055",
            "telephone_number": "601-764-4111",
            "fax_number": "601-764-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAURIN",
        "first_name": "SAMUEL",
        "middle_name": "HUGH",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "288095",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "2880-95",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Springs, MS

Sources for this page

Verify at the official NPI Registry.