Karen Bryant Luckett,DMD,PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2664-92 Issued in MS

Legal business name

KAREN BRYANT LUCKETT,DMD,PLLC

Practice address

1121B Delaware Ave
McComb, MS 39648-3829

Phone

(601) 684-3966

Fax

(601) 684-3875

NPI assigned

Jul 15, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Karen Bryant Luckett, D.M.D.

Title

Owner/Member

Phone

(601) 684-3966

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1386051993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121B DELAWARE AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483829",
            "telephone_number": "601-684-3966",
            "fax_number": "601-684-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121B DELAWARE AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483829",
            "telephone_number": "601-684-3966",
            "fax_number": "601-684-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN BRYANT LUCKETT,DMD,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "LUCKETT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "BRYANT",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "601-684-3966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MS",
            "license": "2664-92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660074",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in McComb, MS
• Providers in McComb, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.