1St Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

1ST DENTAL, LLC

Practice address

313 S 40TH Ave
Hattiesburg, MS 39402-1734

Phone

(601) 264-5100

Fax

(601) 264-6669

NPI assigned

Mar 28, 2016

Last updated

Mar 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph J Daho, DDS

Title

Owner

Phone

(601) 264-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fred H. Drews, III

  • Dentist
  • Hattiesburg, MS
  • NPI 1174680516
  NPD (past)

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1740642834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 S 40TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021734",
            "telephone_number": "601-264-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S 40TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021734",
            "telephone_number": "601-264-5100",
            "fax_number": "601-264-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "DAHO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-264-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06680271",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Hattiesburg, MS
• Providers in Hattiesburg, 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 Mar 28, 2016; 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.