Active NPI
James Richard Kimmelman, DDS
- Periodontics
- Hernando, MS
National Provider Identifier
1346356490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- PER-277-95
- Practice address
- 460 Byhalia Rd
Hernando, MS 38632-1319 - Phone
- (662) 429-5239
- Fax
- (662) 449-0758
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | PER-277-95 | MS | Primary |
Addresses
Primary practice location
460 Byhalia Rd
Hernando, MS 38632-1319
Mailing address
4488 Westminister Cir
Southaven, MS 38671-8594
Phone (662) 449-3654
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 |
|---|---|---|---|
| PER-277-95 | MS | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desoto Family Dental Care,PA | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Hernando, MS
- NPI 1124245444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346356490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4488 WESTMINISTER CIR",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386718594",
"telephone_number": "662-449-3654",
"fax_number": "662-449-3654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 BYHALIA RD",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386321319",
"telephone_number": "662-429-5239",
"fax_number": "662-449-0758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMELMAN",
"first_name": "JAMES",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MS",
"license": "PER-277-95",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hernando, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.