Clastie Dean Umfress, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

324402 Issued in MS

Practice address

579 E Goodman Road Suite #6
Southaven, MS 38671-9433

Phone

(662) 536-2900

Fax

(662) 536-2990

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shing Dental Group, PLLC

  • Dental Clinic/Center
  • Southaven, MS
  • NPI 1992669600
  NPD

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1790857738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 GOODMAN RD E STE 2",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719540",
            "telephone_number": "662-536-2900",
            "fax_number": "662-536-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 E GOODMAN ROAD SUITE #6",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719433",
            "telephone_number": "662-536-2900",
            "fax_number": "662-536-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMFRESS",
        "first_name": "CLASTIE",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3244-02",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "324402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173192192",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DNT173192192",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "southavendentalcare@outlook.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1228 Goodman Rd E Ste 2",
            "city": "Southaven",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386719540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Jordan Tupper
• Meredith Turner
• William Brooks Turner, ATC, LAT
• Turning Point Counseling and Consulting
• Laura S Ullrich
• Unity Hospice NE, LLC
• University of Tennesse
• Upscale Healthcare, LLC
• Upward ABA
• Urgent Medical Clinic Inc

• General Practice Dentistry in Southaven, MS
• Providers in Southaven, 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 Jan 11, 2023; 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.