NPIMap

Organization Active NPI

Mississippi Dental Center of Jackson LLC

  • General Practice Dentistry
  • Jackson, MS
National Provider Identifier
1811620214
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MISSISSIPPI DENTAL CENTER OF JACKSON LLC
Practice address
4500 I 55 N Ste 235
Jackson, MS 39211-5931
Phone
(601) 987-8722
NPI assigned
Jul 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Dr. Clarke Stewart Strange, DMDNPI 1710241344
Title
Owner
Phone
(601) 506-9490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4500 I 55 N Ste 235
Jackson, MS 39211-5931

Mailing address

4500 I 55 N Ste 235
Jackson, MS 39211-5931
Phone (601) 987-8722

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Smile@mississippidentalcenter.com Direct

National Provider Directory

National Provider Directory

Locations

4500 I 55 N
Ste 235
Jackson, MS 39211
Phone (601) 987-8722

Interoperability endpoints

  • Direct secure messaging: smile@mississippidentalcenter.com

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1811620214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 I 55 N STE 235",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115931",
            "telephone_number": "601-987-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 I 55 N STE 235",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115931",
            "telephone_number": "601-987-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI DENTAL CENTER OF JACKSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "STRANGE",
        "authorized_official_first_name": "CLARKE",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-506-9490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Smile@mississippidentalcenter.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4500 I 55 N Ste 235",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392115931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.