Vicksburg Family Dental 61N

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VICKSBURG FAMILY DENTAL 61N

Practice address

1650 Highway 61 N
Vicksburg, MS 39183-3522

Phone

(601) 629-6066

NPI assigned

May 10, 2016

Last updated

May 10, 2016By 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

Dr. Terry Lake Garner, DMD

Title

Owner

Phone

(601) 629-6066

Specialties & licenses 1

Addresses

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.

• Karla Haik, D.M.D.

  • Dentist
  • Flowood, MS
  • NPI 1659785202
  NPD (past)

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1649626573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391833522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391833522",
            "telephone_number": "601-629-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKSBURG FAMILY DENTAL 61N",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "LAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-629-6066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicksburg Clinic LLC
• Vicksburg Community Center
• Vicksburg Convalescent, LLC (Vicksburg Convalescent Center)
• Vicksburg Emergency Physicians LLP
• Vicksburg Family Dental
• Vicksburg HB Medical Services LLC (Merit Health Vicksburg)
• Vicksburg Healthcare LLC (Merit Health River Region)
• Vicksburg Healthcare LLC (River Region Health System)
• Vicksburg Healthcare LLC (River Region Health System)
• Vicksburg Healthcare LLC (Merit Health River Region)

• General Practice Dentistry in Vicksburg, MS
• Providers in Vicksburg, 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 May 10, 2016; 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.