NPIMap

Organization Active NPI

Healthy Smiles Family Dentistry of Pascagoula

Doing business as Healthy Smiles Family Dentistry

  • General Practice Dentistry
  • Pascagoula, MS
National Provider Identifier
1659093250
Registry record updated Oct 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HEALTHY SMILES FAMILY DENTISTRY OF PASCAGOULA
Doing business as
Healthy Smiles Family Dentistry
Healthy Smiles Pascagoula
Practice address
3804 Hospital St
Pascagoula, MS 39581-4167
Phone
(228) 696-2611
Fax
(228) 696-2675
NPI assigned
Sep 12, 2022
Last updated
Oct 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2022

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

Authorized official

Name
Dr. Kinyatta Bennett, DMDNPI 1174829501
Title
Owner
Phone
(228) 696-2611

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
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

3804 Hospital St
Pascagoula, MS 39581-4167

Mailing address

3804 Hospital St
Pascagoula, MS 39581-4167
Phone (228) 696-2611

Other names 2

  • Healthy Smiles Family Dentistry Doing business as
  • Healthy Smiles Pascagoula Doing business as

National Provider Directory

National Provider Directory

Locations

3804 Hospital St
Pascagoula, MS 39581
Phone (228) 641-4792

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664582400000",
    "number": "1659093250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 HOSPITAL ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395814167",
            "telephone_number": "228-696-2611",
            "fax_number": "228-696-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 HOSPITAL ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395814167",
            "telephone_number": "228-696-2611",
            "fax_number": "228-696-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SMILES FAMILY DENTISTRY OF PASCAGOULA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-10-01",
        "certification_date": "2022-10-01",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "KINYATTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-696-2611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Smiles Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthy Smiles Pascagoula",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.