Brookhaven Smile Center, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

339006 Issued in MS

Legal business name

BROOKHAVEN SMILE CENTER, INC

Practice address

1381 Johnny Johnson Dr
Brookhaven, MS 39601-9641

Phone

(601) 823-2990

Fax

(601) 823-2991

NPI assigned

Jun 18, 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. Jeremy Drew King, DMDNPI 1982728580

Title

President

Phone

(601) 823-2990

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, and the practitioner matching its NPPES authorized official.

• Jeremy Drew King, D.M.D.

  • General Practice Dentistry
  • Brookhaven, MS
  • NPI 1982728580
  NPD (past) Authorized official

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922203306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 JOHNNY JOHNSON DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396019641",
            "telephone_number": "601-823-2990",
            "fax_number": "601-823-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 JOHNNY JOHNSON DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396019641",
            "telephone_number": "601-823-2990",
            "fax_number": "601-823-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN SMILE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "DREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-823-2990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "339006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookhaven Ms Operating LLC (Lincoln Residential Center)
• Brookhaven OB-GYN Associates, PA
• Brookhaven Optical Inc (Optical Outlet)
• Brookhaven Psychological Associates
• Brookhaven Radiology PLLC
• Brookhaven Surgery Clinic P.a.
• Brookhaven Urology, PA
• Brown Chiropractic Clinic, LLC
• Bathsheba Brown
• Elizabeth Whitaker Brown, MSN, RN

• General Practice Dentistry in Brookhaven, MS
• Providers in Brookhaven, 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.