Active NPI
Robert Nixon Prospere, DMD
- Dentist
- Natchez, MS
National Provider Identifier
1679781389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1729 76
- Practice address
- 710 N Pearl St
Natchez, MS 39120-2359 - Phone
- (601) 442-4318
- Fax
- (601) 445-9871
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1729 76 | MS | Primary |
Addresses
Primary practice location
710 N Pearl St
Natchez, MS 39120-2359
Mailing address
710 N Pearl St
Natchez, MS 39120-2359
Phone (601) 442-4318
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00660378 | Medicaid | MS | |
| 1729 76 | Other | MS | MS DENTAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1729 76 | MS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1679781389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 N PEARL ST",
"city": "NATCHEZ",
"state": "MS",
"postal_code": "391202359",
"telephone_number": "601-442-4318",
"fax_number": "601-445-9871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 N PEARL ST",
"city": "NATCHEZ",
"state": "MS",
"postal_code": "391202359",
"telephone_number": "601-442-4318",
"fax_number": "601-445-9871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROSPERE",
"first_name": "ROBERT",
"middle_name": "NIXON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "1729 76",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00660378",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS DENTAL LICENSE NUMBER",
"identifier": "1729 76",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Natchez, MS
- Premier Health & Wellness Clinic
- Premier Health & Wellness Clinic LLC
- Premier Imaging Center, LLC
- Premier Personal Care & Respite Services
- Rachel Kimberly Primm
- Thomas L Purvis Jr., M.D.
- Quality Home Oxygen, Inc.
- Radiology Associates of Natchez, P.a.
- Frederick Paul Ragan, MD
- Shaunta Shanell Randall, (BS) PSYCHOLOGY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.