Poplarville Dental Clinic

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3142-00 Issued in MS

Legal business name

POPLARVILLE DENTAL CLINIC

Practice address

1718 South Main Street
Poplarville, MS 39470-4287

Phone

(601) 795-8024

Fax

(601) 795-0745

NPI assigned

Feb 4, 2011

Last updated

Feb 4, 2011By 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. Dustin Gabriel Smith, DMDNPI 1326066481

Title

Dentist

Phone

(601) 795-8024

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Dustin G. Smith, DMD

  • General Practice Dentistry
  • Poplarville, MS
  • NPI 1326066481
  Authorized official Same address or phone

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1306142674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 S MAIN ST",
            "address_2": "MAILING P O BOX 73",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394704287",
            "telephone_number": "601-795-8024",
            "fax_number": "601-795-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 SOUTH MAIN STREET",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394704287",
            "telephone_number": "601-795-8024",
            "fax_number": "601-795-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLARVILLE DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-04",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "601-795-8024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MS",
            "license": "3142-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660344",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pearl River County Hospital Emergency Department
• Pearl River Drug Co.
• Kimberly Philyaw, NP-C
• Picayune Eye Clinic (Poplarville Eye Clinic)
• Nancy Warden Pizzuto, COTA/L
• Poplarville Eye Clinic, LLC
• Poplarville Family Chiropractic
• Poplarville Home Medical LLC
• Poplarville Special Separate Municipal School District
• Prime Med Serves

• Dental Clinic/Center in Poplarville, MS
• Providers in Poplarville, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.