Paul Family Dentistry, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

3846 Issued in MS

Legal business name

PAUL FAMILY DENTISTRY, INC.

Practice address

410 N Jerry Clower Blvd
Yazoo City, MS 39194-8274

Phone

(662) 746-3491

Fax

(662) 746-3946

NPI assigned

Feb 25, 2014

Organization subpart

No

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

Authorized official

Name

Tracy Paul, DMDNPI 1659719334

Title

Owner

Phone

(662) 746-3491

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

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

• Tracy Peyton Paul, DMD

  • General Practice Dentistry
  • Yazoo City, MS
  • NPI 1659719334
  NPD (past) Authorized official
• Stacey Deperro Winford, DMD

  • Dentist
  • Yazoo City, MS
  • NPI 1740308055
  NPD (past)

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1760807994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N JERRY CLOWER BLVD",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391948274",
            "telephone_number": "662-746-3491",
            "fax_number": "662-746-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N JERRY CLOWER BLVD",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391948274",
            "telephone_number": "662-746-3491",
            "fax_number": "662-746-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL FAMILY DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-746-3491",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "3846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04271891",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07223267",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela B Ledbetter
• David J Parker Jr.
• Leigh Parker
• Ouida Parks, LPC
• Candace Patterson
• Tracy Peyton Paul, DMD
• Stephanie Peterson
• Bonnie L Pettigrew, CPSSP
• Jennifer Borgognoni Pickens, DPT
• J Brandon Poe, D.C.

• Dentist in Yazoo City, MS
• Providers in Yazoo City, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.