Katie Sevelda Bearden, DDS

Individual provider Active NPI General Practice Dentistry · Batesville, MS

NPI 1356440135 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1356440135
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2655-91 (MS)
Practice address
221 Gay St
Batesville, MS 38606-1903
Phone
(662) 563-5040
Fax
(662) 563-5018
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2655-91MSMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2655-91 MS Yes

Addresses

Primary practice location

221 Gay St
Batesville, MS 38606-1903

Mailing address

PO Box 1583
Batesville, MS 38606-4083
Phone (662) 563-5040

Other identifiers

IdentifierTypeStateIssuer
00060448MedicaidMS

Other providers in Batesville, MS

All providers in Batesville, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.