Lakeland Periodontics and Implants

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

LAKELAND PERIODONTICS AND IMPLANTS

Practice address

2550 Flowood Dr Ste 401
Flowood, MS 39232-9320

Phone

(601) 271-8710

Fax

(601) 271-6055

NPI assigned

Jun 28, 2022

Last updated

Jun 28, 2022By 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

Kelly Miller

Title

Credentialing Specialist

Phone

(601) 271-8710

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1528790680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DR STE 401",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329320",
            "telephone_number": "601-271-8710",
            "fax_number": "601-271-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 FLOWOOD DR STE 401",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329320",
            "telephone_number": "601-271-8710",
            "fax_number": "601-271-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND PERIODONTICS AND IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "601-271-8710"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas 'Emile' Lagarde, MD
• Lakeland Anesthesia, PLLC
• Lakeland Family Clinic PLLC
• Lakeland Home Program, LLC (Fresenius Medical Care Lakeland Home Program)
• Lakeland Medical Associates LLC
• Lakeland Premier Women's Clinic PLLC
• Lakeland Primary Care Clinic
• Carrie Landers, PHARM D
• Jeffrey T Laseter, M.D.
• Kristy Wagner Laster, LPC

• Dental Clinic/Center in Flowood, MS
• Providers in Flowood, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.