Delta Orthodontic Specialists, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

DELTA ORTHODONTIC SPECIALISTS, LLC

Doing business as

Delta Orthodontic Specialists, LLC

Practice address

2356 Grove St
Vicksburg, MS 39183-2857

Phone

(601) 638-8230

NPI assigned

Aug 3, 2022

Organization subpart

No

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

Authorized official

Name

Elaine Gardner

Title

Office Manager

Phone

(601) 638-8230

Specialties & licenses 1

Addresses

Other names 1

• Delta Orthodontic Specialists, LLC Doing business as

Locations

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1649907387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 GROVE ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832857",
            "telephone_number": "601-638-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 GROVE ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832857",
            "telephone_number": "601-638-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA ORTHODONTIC SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-638-8230"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Orthodontic Specialists, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Decker
• Megann Price Dees, PA-C
• Jessica Delk
• Delta Foot Clinics, Inc (The Foot Clinic)
• Delta Orthodontic Specialists LLC
• Denesia Y Giffin PLLC
• Rhonda C Denman, LMFT
• Georgia Dent, HAIR LOSS SPECIALIST
• Dental Professionals of Mississippi, P.C. (MY Vicksburg Dentist)
• Dermatology and Skin Cancer Clinic, P.a.

• Orthodontics and Dentofacial Orthopedics Dentistry in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.