Meridian Dental Associates

Primary specialty

DentistTaxonomy code 122300000X

License

1841 Issued in MS

Legal business name

MERIDIAN DENTAL ASSOCIATES

Practice address

1411 22ND Ave.
Meridian, MS 39301-2046

Phone

(601) 482-5701

Fax

(601) 483-8401

NPI assigned

Mar 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Robert S Justus, DDS

Title

Owner

Phone

(601) 482-5701

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1801119367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 22ND AVE.",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393012046",
            "telephone_number": "601-482-5701",
            "fax_number": "601-483-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 22ND AVE.",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393012046",
            "telephone_number": "601-482-5701",
            "fax_number": "601-483-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "JUSTUS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-482-5701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "1841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Meridian, MS
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.