Dream Team Family Dentistry, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

3489-08 Issued in MS

Legal business name

DREAM TEAM FAMILY DENTISTRY, PLLC

Practice address

6760 Goodman Rd
Olive Branch, MS 38654

Phone

(662) 470-4621

Fax

(662) 470-4621

NPI assigned

Feb 23, 2009

Last updated

Feb 23, 2009By 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. Venis F Siffrard, DDSNPI 1679734727

Title

Owner

Phone

(662) 470-4621

Specialties & licenses 1

Addresses

Other names 1

• Dream Team Family Dentistry, PLLC Other name

Tax ID family

Dream Team Family Dentistry PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Siffrard Family Dentistry, PLLC

  dba Dreamteam Family Dentistry

  • Dentist
  • Olive Branch, MS
  • NPI 1417351289
  NPD tax ID

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.

• Venis Fils Siffrard, DDS

  • General Practice Dentistry
  • Olive Branch, MS
  • NPI 1679734727
  NPD (past) Authorized official

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1306086954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6760 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547056",
            "telephone_number": "662-470-4621",
            "fax_number": "662-470-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6760 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-470-4621",
            "fax_number": "662-470-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAM TEAM FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "SIFFRARD",
        "authorized_official_first_name": "VENIS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-470-4621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3489-08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dream Team Family Dentistry, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Stephanie Machelle Douglass, PMHNP-BC
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• Colton Dunn, FNP-C
• Jennifer Mardis Durley, PT
• East Park Counseling Services LLC
• Edward Burris Eldred, D.O.

• Dentist in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.