John William Sanders Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

139570 Issued in MS

Practice address

506 Cemetery Street
Sanders Dental Clinic
North Carrollton, MS 38947-0216

Phone

(662) 237-6243

Fax

(662) 237-6243

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jack Sanders Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598826315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "address_2": "506 CEMETERY STREET",
            "city": "NORTH CARROLLTON",
            "state": "MS",
            "postal_code": "389470216",
            "telephone_number": "662-237-6243",
            "fax_number": "662-237-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CEMETERY STREET",
            "address_2": "SANDERS DENTAL CLINIC",
            "city": "NORTH CARROLLTON",
            "state": "MS",
            "postal_code": "389470216",
            "telephone_number": "662-237-6243",
            "fax_number": "662-237-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "139570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "SANDERS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carrollton Family Clinic
• Dr Susan Jenay Neely PLLC
• Maggie Taylor, CFNP
• Tyler Holmes Memorial Hospital
• Kara M. White, FNP

• General Practice Dentistry in North Carrollton, MS
• Providers in North Carrollton, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.