Active NPI
Terry Lake Garner, D.M.D.
- Dentist
- Hattiesburg, MS
National Provider Identifier
1396853701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2940 96
- Practice address
- 117 Thornhill Dr
Hattiesburg, MS 39402 - Phone
- (601) 271-7300
- Fax
- (601) 271-9097
- NPI assigned
- Aug 26, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2940 96 | MS | Primary |
Addresses
Primary practice location
117 Thornhill Dr
Hattiesburg, MS 39402
Mailing address
PO Box 18560
Hattiesburg, MS 39404
Phone (601) 271-7300
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 |
|---|---|---|---|
| 2940 96 | MS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373241600000",
"number": "1396853701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18560",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "39404",
"telephone_number": "601-271-7300",
"fax_number": "601-271-9097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 THORNHILL DR",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "39402",
"telephone_number": "601-271-7300",
"fax_number": "601-271-9097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARNER",
"first_name": "TERRY",
"middle_name": "LAKE",
"name_prefix": "Mr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-26",
"last_updated": "2013-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "2940 96",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.