Active NPI
Trice Warriner Sumner, DDS
- Pediatric Dentistry
- Tupelo, MS
National Provider Identifier
1649373218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- PEDO34400
- Practice address
- 1555 Medical Park Cir
Tupelo, MS 38801 - Phone
- (662) 844-3315
- Fax
- (662) 842-8228
- NPI assigned
- Sep 7, 2006
- Last updated
- Jan 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | PEDO34400 | MS | Primary |
Addresses
Primary practice location
1555 Medical Park Cir
Tupelo, MS 38801
Mailing address
1555 Medical Park Cir
Tupelo, MS 38801
Phone (662) 844-3315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00660366 | Medicaid | MS |
Other names 1
- Miss Laurie Trice Warriner
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PEDO34400 | MS | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Dental Clinic, PA | Pediatric Dentistry | Current | Accepting new patients |
| Richard B Warriner DDS PA | Pediatric Dentistry | Past | Accepting new patients |
Locations
1555 Medical Park Cir
Tupelo, MS 38801
Phone (662) 844-3315
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Children's Dental Clinic
- Pediatric Dentistry
- Tupelo, MS
- NPI 1619579349
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1649373218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 MEDICAL PARK CIR",
"city": "TUPELO",
"state": "MS",
"postal_code": "38801",
"telephone_number": "662-844-3315",
"fax_number": "662-842-8228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 MEDICAL PARK CIR",
"city": "TUPELO",
"state": "MS",
"postal_code": "38801",
"telephone_number": "662-844-3315",
"fax_number": "662-842-8228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMNER",
"first_name": "TRICE",
"middle_name": "WARRINER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MS",
"license": "PEDO34400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00660366",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURIE",
"last_name": "WARRINER",
"middle_name": "TRICE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.