NPIMap

Organization Active NPI

Endodontic Associates, PLLC

  • Endodontics
  • Ridgeland, MS
National Provider Identifier
1619005972
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
ENDO 23993 Issued in MS
Legal business name
ENDODONTIC ASSOCIATES, PLLC
Practice address
301 Northlake Ave
Suite 111
Ridgeland, MS 39157-1718
Phone
(601) 856-6364
Fax
(601) 856-7545
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Dr. Jeffery Brian Pride, D.M.D.NPI 1881806354
Title
Owner
Phone
(601) 856-6364

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X ENDO 23993 MS Primary

Addresses

Primary practice location

301 Northlake Ave
Suite 111
Ridgeland, MS 39157-1718

Mailing address

301 Northlake Ave
Suite 111
Ridgeland, MS 39157-1718
Phone (601) 856-6364

National Provider Directory

National Provider Directory

Locations

301 Northlake Ave
Ste 111
Ridgeland, MS 39157
Phone (601) 856-6364

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1619005972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 NORTHLAKE AVE",
            "address_2": "SUITE 111",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571718",
            "telephone_number": "601-856-6364",
            "fax_number": "601-856-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 NORTHLAKE AVE",
            "address_2": "SUITE 111",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571718",
            "telephone_number": "601-856-6364",
            "fax_number": "601-856-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "PRIDE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-856-6364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MS",
            "license": "ENDO 23993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.