Puckett Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

326503 Issued in MS

Legal business name

PUCKETT FAMILY DENTISTRY

Practice address

6181 Highway 18
Brandon, MS 39042-0000

Phone

(601) 825-0559

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Tullos, DMD

Title

Dentist/Owner

Phone

(601) 825-0559

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tanya M O'Bryan, DMD

  • General Practice Dentistry
  • Brandon, MS
  • NPI 1548430697
  NPD (past)

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1447410089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6181 HIGHWAY 18",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390420000",
            "telephone_number": "601-825-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6181 HIGHWAY 18",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390420000",
            "telephone_number": "601-825-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUCKETT FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "TULLOS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "601-825-0559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "326503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Belaga Price, MD
• Emoni Victoria Price, P-LPC
• Ayana Pride
• Providence Pediatric Therapy, LLC
• Margaret Lowery Pruitt, M.S., CCC/SLP
• Puckett Family Medical Clinic
• Puckett Medical Clinic
• Marilyn Marie Purvis
• Michelle Leigh Purvis, OTR/L
• Quad Intermed Company LLC (MEA Medical Clinics)

• Dentist in Brandon, MS
• Providers in Brandon, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.