NPIMap

Organization Active NPI

Zimmerman Family Dentistry

  • General Practice Dentistry
  • Pass Christian, MS
National Provider Identifier
1780811828
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3387-06 Issued in MS
Legal business name
ZIMMERMAN FAMILY DENTISTRY
Practice address
13165 Vidalia Rd
Pass Christian, MS 39571-9162
Phone
(228) 255-4355
Fax
(228) 255-6761
NPI assigned
Jun 16, 2009
Organization subpart
Yes
Parent organization
ZIMMERMAN FAMILY DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Authorized official

Name
Dr. Emmett Lawrence Zimmerman, DDSNPI 1700090594
Title
President/Owner
Phone
(228) 255-4355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3387-06 MS Primary

Addresses

Primary practice location

13165 Vidalia Rd
Pass Christian, MS 39571-9162

Mailing address

13165 Vidalia Rd
Pass Christian, MS 39571-9162
Phone (228) 255-4355

National Provider Directory

National Provider Directory
Part of
Zimmerman Family Dentistry

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1780811828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "organization_name": "ZIMMERMAN FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ZIMMERMAN FAMILY DENTISTRY",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "EMMETT",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "228-255-4355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3387-06",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pass Christian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.