Active NPI
Casey Brian Heitzmann, DMD
- Dentist
- Ridgeland, MS
National Provider Identifier
1316259153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3555-10
- Practice address
- 207 W Jackson St Ste B
Ridgeland, MS 39157-2355 - Phone
- (601) 707-5585
- Fax
- (601) 707-5586
- NPI assigned
- Jul 9, 2010
- Last updated
- Nov 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3555-10 | MS | Primary |
Addresses
Primary practice location
207 W Jackson St Ste B
Ridgeland, MS 39157-2355
Mailing address
207 W Jackson St Ste B
Ridgeland, MS 39157-2355
Phone (601) 707-5585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3555-10 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heitzmann Dentistry | Dentist | Past | Accepting new patients |
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": "1278633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289260800000",
"number": "1316259153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 W JACKSON ST STE B",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391572355",
"telephone_number": "601-707-5585",
"fax_number": "601-707-5586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 W JACKSON ST STE B",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391572355",
"telephone_number": "601-707-5585",
"fax_number": "601-707-5586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEITZMANN",
"first_name": "CASEY",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-09",
"last_updated": "2010-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "3555-10",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, MS
- Health Heroes of Mississippi, Inc. (Health Heroes of Mississippi)
- Heathcat, Inc (Ridgeland Discount Drugs)
- Connie Renee Hefner, LPTA
- Brittany Kerr Heinsz, SLP
- Heitzmann Dentistry (Magnolia family dental care)
- Emily Ann Heitzmann, D.M.D.
- Cornelius Henderson, DPT
- James Keeton Henderson, LPC
- Ryleigh Henning
- Branden Henry, PHD.M.A., LPC, LMFTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.