Pediatric Dentistry of Gluckstadt

Organization Active NPI Dental Clinic/Center · Gluckstadt, MS

NPI 1821960683 · NPPES record last updated Sep 22, 2025

Key facts

NPI
1821960683
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
Legal business name
PEDIATRIC DENTISTRY OF GLUCKSTADT
Practice address
154 Calhoun Station Pkwy Ste F
Gluckstadt, MS 39110-5544
Phone
(769) 567-1807
Fax
(769) 567-1620
NPI assigned
Sep 22, 2025
Organization subpart
No

Authorized official

Name
Avani Khatri, DDS
Title
Owner
Phone
(769) 567-1807

Practitioners 1

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

National Provider Directory

Locations

154 Calhoun Station Pkwy
Ste F
Gluckstadt, MS 39110
Phone (769) 567-1807

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Yes

Addresses

Primary practice location

154 Calhoun Station Pkwy Ste F
Gluckstadt, MS 39110-5544

Mailing address

154 Calhoun Station Pkwy Ste F
Gluckstadt, MS 39110-5544
Phone (769) 567-1807

Other providers in Gluckstadt, MS

All providers in Gluckstadt, MS · Dental Clinic/Center in Mississippi

Sources for this page

Verify at the official NPI Registry.