Eleanor Karen Pruitt, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2295-86 Issued in MS

Practice address

115 Bridgeton PLZ
Jackson, MS 39272-8711

Phone

(601) 372-2351

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1598876161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BRIDGETON PLZ",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392728711",
            "telephone_number": "601-372-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRIDGETON PLZ",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392728711",
            "telephone_number": "601-372-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "ELEANOR",
        "middle_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2295-86",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "64-0903196",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prosperity Counseling Service LLC
• Adam Nicholas Protos, M.D.
• Providence Hospice, LLC
• Thomas Prude, PCMHT
• Ellyn Burton Pruett, FNP-C
• Kelli Elizabeth Pruitt
• Shapard H Pryor Jr., MD
• Tyranny Pryor
• Rick A Psonak, CPO
• John Austin Puckett, MD

• General Practice Dentistry in Jackson, MS
• Providers in Jackson, 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 Dec 2, 2010; 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.