Petal Dental Properties

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PETAL DENTAL PROPERTIES

Doing business as

Pediatric Dental Group of Petal

Practice address

34 Beech Lane
Petal, MS 39465

Phone

(601) 336-0336

NPI assigned

Aug 10, 2026

Last updated

Aug 10, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

PETAL DENTAL PROPERTIESAs reported in NPPES

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

Authorized official

Name

Tina Myers

Title

Practice Manager

Phone

(601) 450-6060

Specialties & licenses 1

Addresses

Other names 1

• Pediatric Dental Group of Petal Doing business as

Tax ID family

Petal Dental Properties2 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.

• Petal Dental Properties

  • Pediatric Dentistry
  • Hattiesburg, MS
  • NPI 1710826094
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Petal Dental Properties

  • Pediatric Dentistry
  • Hattiesburg, MS
  • NPI 1710826094
  NPPES parent name

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

{
    "created_epoch": "1786320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1487578597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6643 U S HIGHWAY 98",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028442",
            "telephone_number": "604-336-0336",
            "fax_number": "601-336-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BEECH LANE",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "39465",
            "telephone_number": "601-336-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETAL DENTAL PROPERTIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PETAL DENTAL PROPERTIES",
        "enumeration_date": "2026-08-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "601-450-6060"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Group of Petal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paki Inc (Central Family Clinic)
• Kimberly Nicole Patrick
• Joseph J Patterson, DPT
• Robert Perez
• Petal Chiropractic Clinic, Inc.
• Petal Drug Company, Inc.
• Petal Family Dentistry
• Petal Middle School
• Petal Primary School
• Petal School Clinic

• Pediatric Dentistry in Petal, MS
• Providers in Petal, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.