Friends of Mississippi Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FRIENDS OF MISSISSIPPI DENTISTRY

Practice address

105 N Brooks Ave
Pelahatchie, MS 39145-3091

Phone

(601) 854-5001

NPI assigned

Sep 25, 2023

Organization subpart

No

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

Authorized official

Name

Sreenivas Koka, DDS

Title

Board Member

Phone

(619) 456-3712

Specialties & licenses 1

Addresses

Practitioners 1

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

• Bradley Emmett Williams, DMD

  • General Practice Dentistry
  • Pelahatchie, MS
  • NPI 1720098908
  NPD (past)

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1831978469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 CLAIBORNE CHASE",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391579706",
            "telephone_number": "619-456-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N BROOKS AVE",
            "city": "PELAHATCHIE",
            "state": "MS",
            "postal_code": "391453091",
            "telephone_number": "601-854-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS OF MISSISSIPPI DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "KOKA",
        "authorized_official_first_name": "SREENIVAS",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "619-456-3712",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Plus Pelahatchie Clinic
• Shanna Posey Davis, RN
• Christy Scafidel Emerson, LCMHT
• Erin Irby Fairley, LCSW
• Family Health Care Clinic, Inc.
• Griffin Family Medical Clinic PA
• Mary Ann Griffin
• Charles D Guess, MD
• Kathy Hill, NP
• Amanda L Jackson, PHARMD

• Dental Clinic/Center in Pelahatchie, MS
• Providers in Pelahatchie, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.