Yazoo City Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

YAZOO CITY DENTAL CLINIC

Practice address

1615 Easy Street
Yazoo, MS 39194-2427

Phone

(662) 746-1432

Fax

(662) 746-5974

NPI assigned

Mar 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Newman Nelson Jr., DDS

Title

Owner

Phone

(662) 746-1432

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Reid Brown, D.M.D.

  • Dentist
  • Yazoo City, MS
  • NPI 1083843551
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871622753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 EASY STREET",
            "city": "YAZOO",
            "state": "MS",
            "postal_code": "391942427",
            "telephone_number": "662-746-1432",
            "fax_number": "662-746-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 EASY STREET",
            "city": "YAZOO",
            "state": "MS",
            "postal_code": "391942427",
            "telephone_number": "662-746-1432",
            "fax_number": "662-746-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAZOO CITY DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "NEWMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-746-1432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015614",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracey Goldman

• General Practice Dentistry in Yazoo, MS
• Providers in Yazoo, 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 Aug 22, 2020; 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.