Stephen H. Blair III, DMD
Individual provider Active NPI General Practice Dentistry · Corinth, MS
NPI 1285722009 · NPPES record last updated Oct 15, 2015
Key facts
- NPI
- 1285722009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2331-87 (MS)
- Practice address
- 3127 N. Shiloh Road
Corinth, MS 38834-2910 - Phone
- (662) 287-3373
- Fax
- (662) 287-3372
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160322001676 | MS | Order and Referring Only - Dentist |
0143527945 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2331-87 | MS | Yes |
Addresses
Primary practice location
3127 N. Shiloh Road
Corinth, MS 38834-2910
Mailing address
3127 North Shiloh Road
Corinth, MS 38834-2910
Phone (662) 287-3373
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00060307 | Medicaid | MS |
Other providers in Corinth, MS
- Philip Anthony Bickert
- Bickerts Orthotics & Prosthetics
- Jamie Leann Bishop
- Lindsay Bishop
- Hayley Alyssa Black
- Blavo Medical Group
- Alan Lee Blunt
- Lacona Blunt
- Boa Vida Hospital of Aberdeen, Ms, LLC
- Boa Vida Hospital of Aberdeen, Ms, LLC
All providers in Corinth, MS · General Practice Dentistry in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.