NPIMap

Organization Active NPI

Hattiesburg Road Dental, P.C.

Doing business as Sunnybrook Dentistry

  • General Practice Dentistry
  • Jackson, MS
National Provider Identifier
1689864662
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HATTIESBURG ROAD DENTAL, P.C.
Doing business as
Sunnybrook Dentistry
Sunnybrook Dentistry & Braces
Practice address
989 Ellis Ave
Jackson, MS 39209-6256
Phone
(678) 904-5665
Fax
(678) 904-5666
NPI assigned
Jul 26, 2007
Last updated
Apr 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Dr. Dale G Mayfield, DMD
Title
Owner
Phone
(770) 916-5036

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X
General Practice Dentistry 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X

Addresses

Primary practice location

989 Ellis Ave
Jackson, MS 39209-6256

Mailing address

210 Interstate North Pkwy SE Ste 300
Atlanta, GA 30339-2233
Phone (770) 916-5028

Other names 2

  • Sunnybrook Dentistry Doing business as
  • Sunnybrook Dentistry & Braces Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hattiesburg Road Dental PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

989 Ellis Ave
Jackson, MS 39209
Phone (601) 354-3557

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1689864662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 INTERSTATE NORTH PKWY SE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392233",
            "telephone_number": "770-916-5028",
            "fax_number": "678-247-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 ELLIS AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392096256",
            "telephone_number": "678-904-5665",
            "fax_number": "678-904-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG ROAD DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "MAYFIELD",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-916-5036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunnybrook Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sunnybrook Dentistry & Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 27, 2026; 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.