Suzanna Ellzey Nida, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

3794-15 Issued in MS

Practice address

4348 Lincoln Rd.
Hattiesburg, MS 39402

Phone

(601) 261-5552

NPI assigned

Jun 4, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1366822397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 AVERY KNOLL",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 LINCOLN RD.",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-261-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3425 Pemberton Square Blvd",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MS",
            "postal_code": "391805574",
            "country_code": "US",
            "telephone_number": "601-636-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIDA",
        "first_name": "SUZANNA",
        "middle_name": "ELLZEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MS",
            "license": "3794-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James A Nicholson, DDS MS
• Lashander Nicholson, IDD WAIVER SERVICES
• Regan Ashley Nicholson I
• Nicole Lynn Nickell, LICENSED ESTHETICIAN
• Andrew Merlan Nida, MD
• Sharon Suzanne Nightengale, PMHNP
• Emily Nix, MD
• Bridget Nobles, CMHT
• Nool Counseling Center, PLLC
• Frederick E Nora, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.