Mai Lati

Primary specialty

DentistTaxonomy code 122300000X

License

4340-22 Issued in MS

Practice address

430 Broad St
Columbia, MS 39429-3006

Phone

(601) 736-7125

NPI assigned

Nov 16, 2022

Last updated

Nov 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moore Family Dental, PLLC

  dba Columbia Family Dental

  • General Practice Dentistry
  • Columbia, MS
  • NPI 1992695571
  NPD

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1801505052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293006",
            "telephone_number": "601-736-7125",
            "fax_number": "601-736-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293006",
            "telephone_number": "601-736-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATI",
        "first_name": "MAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4340-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana R Keith, W.H.N.P.
• Ginny Warren Kemp, L.P.C.
• Jerry Lynn Kimble, D.C.
• Lab & Geaux LLC
• Baneka Lane, OWNER
• Thuy Le
• Carlton Allen Lee
• Halle Leggett, FNP-BC
• Shannon Haney Loftin, FNP-C
• Love & Compassion Health Service

• Dentist in Columbia, MS
• Providers in Columbia, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.