Ms Periodontic Specialists Group, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

45012 Issued in MS

Legal business name

MS PERIODONTIC SPECIALISTS GROUP, PLLC

Practice address

209 Woodline Dr.
Flowood, MS 39232

Phone

(601) 664-2600

Fax

(601) 664-2650

NPI assigned

Aug 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Reid Lester, DMD

Title

Owner

Phone

(601) 664-2600

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Robert Wayne Rives, D.D.S.

  • Dentist
  • Flowood, MS
  • NPI 1558783308
  NPD (past)

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1851640437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 WOODLINE DR.",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-664-2600",
            "fax_number": "601-664-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WOODLINE DR.",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "39232",
            "telephone_number": "601-664-2600",
            "fax_number": "601-664-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS PERIODONTIC SPECIALISTS GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "REID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-664-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MS",
            "license": "45012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raegan Mobley Morris, NP
• Brittany O'Steen Morrow, CRNA
• Rebekah Moulder, M.D.
• Ms Center for Orofacial Pain & Dental Sleep Medicine LLC
• Ms Hma DME LLC
• Daniel C Mullins, M.D.
• Jill Chennault Murphy, RNFA
• Cheryl Murray, NNP
• Donald S Murray, M.D.
• Courtney Dannielle Murtagh, WHNP

• Periodontics in Flowood, MS
• Providers in Flowood, MS by specialty
• Periodontics in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.