Individual provider Active NPI

Christina Granier Robertson, DDS

  • Dentist
  • Gulfport, MS
National Provider Identifier
1306412895
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7240 Issued in LA
Practice address
9354 Highway 49 Ste L
Gulfport, MS 39503-4226
Phone
(228) 206-1234
NPI assigned
Jun 3, 2021
Last updated
Jul 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4312-22 MS
Dentist 122300000X 7240 LA Primary

Addresses

Primary practice location

9354 Highway 49 Ste L
Gulfport, MS 39503-4226

Mailing address

9354 Highway 49 Ste L
Gulfport, MS 39503-4226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20210622003305 LA Order and Referring Only - DentistPractitioner - Dentist 7719388289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4312-22MSMDDentist
7240LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Mississippi Smiles Dentistry LLC CurrentSince Nov 24, 2025 Accepting new patients

Locations

9354 Highway 49
Ste L
Gulfport, MS 39503
Phone (228) 206-1234

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1306412895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9354 HIGHWAY 49 STE L",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9354 HIGHWAY 49 STE L",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034226",
            "telephone_number": "228-206-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "CHRISTINA",
        "middle_name": "GRANIER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4312-22",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.