Westside Dental, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

303298 Issued in MS

Legal business name

WESTSIDE DENTAL, PLLC

Practice address

3694 W Jackson St
Tupelo, MS 38801

Phone

(662) 842-8035

Fax

(662) 842-3018

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Lee Austin, DMDNPI 1043405590

Title

Manager

Phone

(662) 842-8035

Specialties & licenses 2

Addresses

Other names 1

• Austin Dental Clinic PC Former legal business name

Locations

Practitioners 2

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

• Kenneth Lee Austin, DMD

  • Dentist
  • Tupelo, MS
  • NPI 1043405590
  NPD (past) Authorized official
• Mindelyn Tustain Austin, DMD

  • Dentist
  • Tupelo, MS
  • NPI 1851586309
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1669596318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3694 W JACKSON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-842-8035",
            "fax_number": "662-842-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3694 W JACKSON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38801",
            "telephone_number": "662-842-8035",
            "fax_number": "662-842-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-842-8035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "303298",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "298897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Austin Dental Clinic PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• William F. West, D.M.D., M.D.
• T'Keyah Westbrook
• Sara Westmoreland Smith
• Ashlee Nicole Westmoreland, SLP
• Luke Westphal
• Westside Family Medical Clinic of Tupelo LLC
• Westside Pharmacy & Gifts
• Daniel Whitcomb, DO
• Amanda Leshea White
• Anna Claire White, PHARM.D.

• Dentist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.