NPIMap

Organization Active NPI

Medical Arts Dental Group P.a.

  • General Practice Dentistry
  • Jackson, MS
National Provider Identifier
1659539351
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
228886 Issued in MS
Legal business name
MEDICAL ARTS DENTAL GROUP P.A.
Practice address
1151 N State St
Suite 401
Jackson, MS 39202-2407
Phone
(601) 948-2073
Fax
(601) 354-8773
NPI assigned
May 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Dr. Robert Jerry Neely, D.M.D.NPI 1558423764
Title
Owner/ Dentist
Phone
(601) 948-2073

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 228886 MS Primary

Addresses

Primary practice location

1151 N State St
Suite 401
Jackson, MS 39202-2407

Mailing address

1151 N State St
Suite 401
Jackson, MS 39202-2407
Phone (601) 948-2073

National Provider Directory

National Provider Directory

Locations

1151 N State St
Ste 401
Jackson, MS 39202
Phone (601) 948-2073

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1659539351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 401",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-948-2073",
            "fax_number": "601-354-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N STATE ST",
            "address_2": "SUITE 401",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022407",
            "telephone_number": "601-948-2073",
            "fax_number": "601-354-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ARTS DENTAL GROUP P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JERRY",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "601-948-2073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "228886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.