Pediatric Dentistry of Ridgeland, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTISTRY OF RIDGELAND, PLLC

Practice address

297 Highway 51 Ste D
Ridgeland, MS 39157-3423

Phone

(601) 856-4428

Fax

(601) 856-3310

NPI assigned

Sep 18, 2019

Organization subpart

No

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

Authorized official

Name

Tiffany Priscilla Green, DMD

Title

Pediatric Dentist

Phone

(601) 497-2550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1902456247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 HIGHWAY 51 STE D",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573423",
            "telephone_number": "601-856-4428",
            "fax_number": "601-856-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 HIGHWAY 51 STE D",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391573423",
            "telephone_number": "601-856-4428",
            "fax_number": "601-856-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF RIDGELAND, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "PRISCILLA",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "601-497-2550",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Wiebelt Paul, OT
• Sonya Pawloski, S.L.P.
• William David Payne, M.D.
• Abigail Rose Peavey
• Niketa C Pechan, LCSW
• Pediatric Place, LLC
• Walker Nelson Pedigo, DDS
• Catherine Ranck Perez
• Performance Rehab, Inc
• Johnny Julian Perkins Jr., PTA

• Pediatric Dentistry in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.