NPIMap

Organization Active NPI

Dental Professionals of Mississippi, P.C.

  • General Practice Dentistry
  • Madison, MS
National Provider Identifier
1851086052
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Doing business as
Gluckstadt Family Dental
Practice address
1716 Highway 51 Ste G
Madison, MS 39110-5020
Phone
(601) 790-9245
NPI assigned
Apr 5, 2023
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

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

Addresses

Primary practice location

1716 Highway 51 Ste G
Madison, MS 39110-5020

Mailing address

1716 Highway 51 Ste G
Madison, MS 39110-5020

Other names 1

  • Gluckstadt Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Mississippi PC9 organizations share this tax ID, including this one
Part of
Dental Professionals of Mississippi PC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1716 Highway 51
Ste G
Madison, MS 39110
Phone (601) 790-9245

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1680652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1851086052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 HIGHWAY 51 STE G",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391105020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 HIGHWAY 51 STE G",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391105020",
            "telephone_number": "601-790-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gluckstadt Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, MS

Sources for this page

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