Mississippi Orofacial Pain, LLC

Primary specialty

Orofacial Pain DentistryTaxonomy code 1223X2210X

Legal business name

MISSISSIPPI OROFACIAL PAIN, LLC

Doing business as

Mississippi Orofacial Pain Specialists

Practice address

108 S Maple St Ste C
Ridgeland, MS 39157-2305

Phone

(601) 720-7662

NPI assigned

Apr 27, 2022

Last updated

Dec 28, 2023By 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

Paul Coleman Riley, D.D.S.NPI 1285640383

Title

Authorized Official

Phone

(769) 567-2555

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• Mississippi Orofacial Pain Specialists Doing business as
• Mississippi Orofacial Pain Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Riley, D.D.S.

  • Orofacial Pain Dentistry
  • Ridgeland, MS
  • NPI 1285640383
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1639813454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S MAPLE ST STE C",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572357",
            "telephone_number": "697-567-2555",
            "fax_number": "769-567-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S MAPLE ST STE C",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572305",
            "telephone_number": "601-720-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI OROFACIAL PAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "COLEMAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "769-567-2555",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1285640383",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCATION NPI",
            "identifier": "1639813454",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drpaul@mississippitmj.com",
            "affiliation": "N",
            "address_1": "108 South Maple St",
            "address_2": "Suite C",
            "city": "Ridgeland",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drpaul@mississippitmj.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "108 South Maple St",
            "address_2": "Suite C",
            "city": "Ridgeland",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mississippi Orofacial Pain Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mississippi Orofacial Pain",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mississippi Orofacial Pain",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Orofacial Pain Dentistry in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Orofacial Pain Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.