Active NPI
Cayla Lloyd Dickerson, DMD
- Dentist
- Raleigh, MS
National Provider Identifier
1508693177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 448324
- Practice address
- 276 Magnolia Dr
Raleigh, MS 39153-6016 - Phone
- (601) 782-9909
- NPI assigned
- Sep 17, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 448324 | MS | Primary |
Addresses
Primary practice location
276 Magnolia Dr
Raleigh, MS 39153-6016
Mailing address
554 N Old Canton Rd
Madison, MS 39110-8111
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 |
|---|---|---|---|
| 448324 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tullos Family Dentistry, PA | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Raleigh, MS
- NPI 1467519827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1508693177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "554 N OLD CANTON RD",
"city": "MADISON",
"state": "MS",
"postal_code": "391108111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "276 MAGNOLIA DR",
"city": "RALEIGH",
"state": "MS",
"postal_code": "391536016",
"telephone_number": "601-782-9909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "CAYLA",
"middle_name": "LLOYD",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-17",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "448324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.