NPIMap

Organization Active NPI

Albert W. Tutor, Jr., D.M.D. PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brandon, MS
National Provider Identifier
1477796977
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
3161-00 Issued in MS
Legal business name
ALBERT W. TUTOR, JR., D.M.D. PA
Practice address
25 Eastgate Dr
Suite a
Brandon, MS 39042-2317
Phone
(601) 824-3500
Fax
(601) 824-3501
NPI assigned
Apr 13, 2009
Last updated
Apr 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Authorized official

Name
Dr. Albert Wayne Tutor Jr., D.M.D.NPI 1255439501
Title
Orthodontist
Phone
(601) 824-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 3161-00 MS Primary

Addresses

Primary practice location

25 Eastgate Dr
Suite a
Brandon, MS 39042-2317

Mailing address

25 Eastgate Dr
Suite a
Brandon, MS 39042-2317
Phone (601) 824-3500

Other identifiers 1

IdentifierTypeStateIssuer
00660444MedicaidMS

National Provider Directory

National Provider Directory

Locations

25 Eastgate Dr
#A
Brandon, MS 39042
Phone (601) 824-3500

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1477796977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 EASTGATE DR",
            "address_2": "SUITE A",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422317",
            "telephone_number": "601-824-3500",
            "fax_number": "601-824-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 EASTGATE DR",
            "address_2": "SUITE A",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422317",
            "telephone_number": "601-824-3500",
            "fax_number": "601-824-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERT W. TUTOR, JR., D.M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "TUTOR",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "601-824-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MS",
            "license": "3161-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660444",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.