Siffrard Family Dentistry, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

348908 Issued in MS

Legal business name

SIFFRARD FAMILY DENTISTRY, PLLC

Doing business as

Dreamteam Family Dentistry

Practice address

6760 Goodman Rd
Olive Branch, MS 38654

Phone

(662) 895-3000

Fax

(662) 895-3021

NPI assigned

Oct 22, 2014

Last updated

Oct 22, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Janita Alexander Siffrard, D.D.S.

Title

Dentist/Owner

Phone

(662) 895-3000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dreamteam Family Dentistry Doing business as

Tax ID family

Dream Team Family Dentistry PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dream Team Family Dentistry, PLLC

  • Dentist
  • Olive Branch, MS
  • NPI 1306086954
  NPD tax ID

Locations

Practitioners 2

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.

• Janita Alexander, DDS

  • Dentist
  • Olive Branch, MS
  • NPI 1548607120
  NPD (past)
• Venis Fils Siffrard, DDS

  • General Practice Dentistry
  • Olive Branch, MS
  • NPI 1679734727
  NPD (past)

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1417351289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6760 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-895-3000",
            "fax_number": "662-895-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6760 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-895-3000",
            "fax_number": "662-895-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIFFRARD FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "SIFFRARD",
        "authorized_official_first_name": "JANITA",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "662-895-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "348908",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3686-13",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09822823",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09523504",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dreamteam Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phillip Shockley, DDS
• Sharon Short, OTA
• Zanetriah Shorty
• Jessica Ann Shoup, PHARM.D.
• Sidhu Pediatrics, LLC (Desoto Children's Clinic - Olive Branch)
• Venis Fils Siffrard, DDS
• Alicia G Sims, PHARM D
• Katashia Singleton
• Melissa Verkler Slade, MOT,OTR/L
• Smiley Physical Therapy LLC

• Dentist in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.