Eric L Hyde, DDS PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3330-05 Issued in MS

Practice address

15236 Dedeaux Rd
Gulfport, MS 39503-3161

Phone

(228) 832-3111

Fax

(228) 832-3117

NPI assigned

Aug 12, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Gulf Coast Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Gulfport, MS
  • NPI 1194004994
  NPD Authorized official

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1609888197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15236 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033161",
            "telephone_number": "228-832-3111",
            "fax_number": "228-832-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15236 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033161",
            "telephone_number": "228-832-3111",
            "fax_number": "228-832-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "ERIC",
        "middle_name": "L",
        "credential": "DDS PLLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "3330-05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03781882",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "04472876",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX I.D. NUMBER",
            "identifier": "510579833",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Elizabeth Hutchison, NP
• Cory Hutto, PHARMD
• Davis Hutto, CRNA
• Warren Patrick Hutto, PHARMD
• Brandy L Hyde, D.D.S.
• I Care Optical, Inc.
• Ida Care LLC
• Matthew Raymond Illich, PHARMD
• Jayapriya Immanuel, MD
• Infinity Home Care Services LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.