NPIMap

Organization Active NPI

Gulf Islands Dentistry, PLLC

  • Dentist
  • Pascagoula, MS
National Provider Identifier
1831576644
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
333605 Issued in MS
Legal business name
GULF ISLANDS DENTISTRY, PLLC
Practice address
1226 Jackson Ave
Pascagoula, MS 39567-4348
Phone
(228) 769-9010
Fax
(228) 762-0303
NPI assigned
Apr 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Dr. Russell Parker, D.M.D.NPI 1407061252
Title
President
Phone
(228) 769-9010

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 333605 MS Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 375014 MS

Addresses

Primary practice location

1226 Jackson Ave
Pascagoula, MS 39567-4348

Mailing address

1226 Jackson Ave
Pascagoula, MS 39567-4348
Phone (228) 769-9010

National Provider Directory

National Provider Directory

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": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1831576644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 JACKSON AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395674348",
            "telephone_number": "228-769-9010",
            "fax_number": "228-762-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 JACKSON AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395674348",
            "telephone_number": "228-769-9010",
            "fax_number": "228-762-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF ISLANDS DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "228-769-9010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "333605",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "375014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.