Booneville General Dentistry, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3645 12 Issued in MS

Legal business name

BOONEVILLE GENERAL DENTISTRY, P.A.

Practice address

507 E Church St
Booneville, MS 38829-3709

Phone

(662) 728-2123

Fax

(662) 728-1748

NPI assigned

May 26, 2015

Last updated

May 26, 2015By 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. Samuel Robert Hall, DMD

Title

Pres

Phone

(662) 728-2123

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Jeff Johnson, D.M.D.

  • General Practice Dentistry
  • Booneville, MS
  • NPI 1174622807
  NPD (past)
• Austin Brock Parris, DDS

  • Dentist
  • Booneville, MS
  • NPI 1457272692
  NPD (past)

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1881073716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 E CHURCH ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293709",
            "telephone_number": "662-728-2123",
            "fax_number": "662-728-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 E CHURCH ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293709",
            "telephone_number": "662-728-2123",
            "fax_number": "662-728-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONEVILLE GENERAL DENTISTRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "662-728-2123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3645 12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09234892",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Booneville Assisted Living LLC
• Booneville Chiropractic Clinic, P.a.
• Booneville Community Pharmacy of Ms Inc.
• Booneville Community Pharmacy of Msinc (Booneville Community Pharmacy)
• Booneville Discount Drugs Inc
• Booneville Internal Medicine PC
• Booneville Wellness, LLC
• Halley Box, APRN
• Brandon Johnson Booneville Anesthesia Services
• Christy Brantley

• General Practice Dentistry in Booneville, MS
• Providers in Booneville, 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 May 26, 2015; 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.