Medical Arts Dental North Jackson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

228886 Issued in MS

Legal business name

MEDICAL ARTS DENTAL NORTH JACKSON

Practice address

4801 Old Canton Rd
Jackson, MS 39211-5522

Phone

(601) 948-2073

Fax

(601) 354-8773

NPI assigned

Mar 14, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Robert J Neely, DMD

Title

Dentist/Owner

Phone

(601) 948-2073

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1841565538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115522",
            "telephone_number": "601-948-2073",
            "fax_number": "601-354-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115522",
            "telephone_number": "601-948-2073",
            "fax_number": "601-354-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ARTS DENTAL NORTH JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "601-948-2073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "228886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04831314",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Med-Trans Corporation
• Nicholas Fouad George Medawar, MD
• Medfusion, LLC
• Medi Start Inc
• Medical Arts Dental Group P.a.
• Medical Assurance LLC
• Medical Billing Strategies, LLC
• Medical Care Alliance LLC
• Medical Care Associates Mobile Unit
• Medical Care Associates P a

• General Practice Dentistry in Jackson, MS
• Providers in Jackson, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.