Long Family Dentistry Inc

Primary specialty

DentistTaxonomy code 122300000X

License

186980 Issued in MS

Legal business name

LONG FAMILY DENTISTRY INC

Practice address

527 Desoto Avenue
Clarksdale, MS 38614

Phone

(662) 627-2565

Fax

(662) 627-2524

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Robert E Long Sr., DDSNPI 1437332160

Title

President Dentist

Phone

(662) 627-2565

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Robert Earl Long Sr., DDS

  • Dentist
  • Clarksdale, MS
  • NPI 1437332160
  NPD (past) Authorized official

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811050313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 291",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "38614",
            "telephone_number": "662-627-2565",
            "fax_number": "662-627-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 DESOTO AVENUE",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "38614",
            "telephone_number": "662-627-2565",
            "fax_number": "662-627-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG FAMILY DENTISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT DENTIST",
        "authorized_official_telephone_number": "662-627-2565",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "186980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00064885",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Chandler Lewis, NP
• Jeanne Mariah Lilly, PHD
• Lion Hospice & Palliative Care, LLC
• Kolby Nicole Little, MED, LPC, NCC
• Lillie Mae Lockett
• Robert Earl Long Sr., DDS
• Shirley Long, M.ED.
• Dalisa Lusby
• James W Major, M.D.
• Carole L Mangrem, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.