Hattiesburg Community Dental Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

HATTIESBURG COMMUNITY DENTAL CENTER

Doing business as

Hattiesburg Community Dental Center

Practice address

68 Old Airport Rd
Hattiesburg, MS 39401-8382

Phone

(601) 583-4800

Fax

(601) 584-7769

NPI assigned

Jul 14, 2006

Last updated

Feb 6, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INCAs reported in NPPES

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

Authorized official

Name

Janice Robinson

Title

Ceo

Phone

(601) 545-8700

Specialties & licenses 1

Addresses

Other names 1

• Hattiesburg Community Dental Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366468266. Details of each certification follow.

• CCN 251174 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 251174

Legal name

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.

Doing business as

HATTIESBURG COMMUNITY DENTAL CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 4, 2025

Last certification

Sep 4, 2025

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

68 Old Airport Rd
Hattiesburg, MS 39401-8382

Tax ID family

Bellevue Elementary59 organizations share this tax ID, including this one

Part of

Bellevue Elementary

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Brooklyn Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, MS
  • NPI 1659348076
  NPD tax ID
• Dixie Attendance Center

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1164462610
  NPD tax ID
• Forrest County Agricultural High School

  dba Forrest Agricultural High School

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, MS
  • NPI 1407363559
  NPD tax ID
• Hattiesburg High School Campus Clinic

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1427328889
  NPD tax ID
• Hawkins Elementary School

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1194783985
  NPD tax ID
• Lumberton Elementary School

  • Federally Qualified Health Center (FQHC)
  • Lumberton, MS
  • NPI 1538733795
  NPD tax ID
• Lumberton Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Lumberton, MS
  • NPI 1164499174
  NPD tax ID
• Lumberton High School

  dba Lumberton High School (9-12)

  • Federally Qualified Health Center (FQHC)
  • Lumberton, MS
  • NPI 1356915516
  NPD tax ID
• Minor Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1508874769
  NPD tax ID
• N R Burger School and Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1518907054
  NPD tax ID
• North Forrest Jr/Sr High School

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1548206857
  NPD tax ID
• Oak Grove Longleaf

  • Federally Qualified Health Center (FQHC)
  • Hattiesburg, MS
  • NPI 1053985226
  NPD tax ID

Locations

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

All facility ownership & control disclosures 37

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 64

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.

• Johanna M Alvarez, MSN, FNP-BC

  • Family Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1588219083
  NPD
• Senate Oluwakemi Amusu, MD

  • Infectious Disease Physician
  • Hattiesburg, MS
  • NPI 1700309432
  NPD
• Trish Anne Brix-Baskin, LCSW

  • Clinical Social Worker
  • Petal, MS
  • NPI 1316206519
  NPD
• Brandon L Coleman, D. O.

  • Family Medicine Physician
  • Sumrall, MS
  • NPI 1881685782
  NPD
• Patricia M Curb-Varnado, LCSW

  • Clinical Social Worker
  • Hattiesburg, MS
  • NPI 1821834870
  NPD
• Charles F Diamond, FNP-BC

  • Family Nurse Practitioner
  • Brooklyn, MS
  • NPI 1659844496
  NPD
• Ronda Carol Eason-Hinton, FNP-BC

  • Family Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1952570723
  NPD
• Quenyatta Echols-Williams, M.D.

  • Internal Medicine Physician
  • Hattiesburg, MS
  • NPI 1255392841
  NPD
• Anny S Evans, NP

  • Family Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1346712791
  NPD
• Melanie Lynn Frierson, FNP-C

  • Family Nurse Practitioner
  • Picayune, MS
  • NPI 1720659758
  NPD
• Lauren O'Neal Garner, FNP-C

  • Family Nurse Practitioner
  • Petal, MS
  • NPI 1881199818
  NPD
• Allison Garrett, NP

  • Pediatric Nurse Practitioner
  • Petal, MS
  • NPI 1851161855
  NPD

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770336000000",
    "number": "1366468266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1729",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394031729",
            "telephone_number": "601-545-8700",
            "fax_number": "601-450-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 OLD AIRPORT RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018382",
            "telephone_number": "601-583-4800",
            "fax_number": "601-584-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG COMMUNITY DENTAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-545-8700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hattiesburg Community Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hattiesburg Community Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Federally Qualified Health Center (FQHC) in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Federally Qualified Health Center (FQHC) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.