Jessica Marie McMichael, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3438-07 Issued in MS

Practice address

13165 Vidalia Rd
Pass Christian, MS 39571-9162

Phone

(228) 255-4355

Fax

(228) 255-6761

NPI assigned

Feb 19, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Charles G. Wood D.M.D.P.a.

  • General Practice Dentistry
  • Gulfport, MS
  • NPI 1063430924

  General Practice

  NPD (past)

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1679712376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 BROAD AVE STE 1",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012475",
            "telephone_number": "228-863-5171",
            "fax_number": "228-863-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13165 VIDALIA RD",
            "city": "PASS CHRISTIAN",
            "state": "MS",
            "postal_code": "395719162",
            "telephone_number": "228-255-4355",
            "fax_number": "228-255-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMICHAEL",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3438-07",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Living Waters Community Medical Center PLLC
• Loves Pharmacy & Gifts Inc
• Chelsea Irene Mazzulo, LMFT
• Natalie McGraw
• Stephanie A. McLeod, NP-C
• Philip Albert McShane, PHARMD
• Memorial Hospital at Gulfport
• Rachel Louise Meredith
• Christine Miller, LPC
• Mind Repose LLC

• General Practice Dentistry in Pass Christian, MS
• Providers in Pass Christian, 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 Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.