North Mississippi Periodontics & Implant Dentistry PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2571-90 Issued in MS

Legal business name

NORTH MISSISSIPPI PERIODONTICS & IMPLANT DENTISTRY PLLC

Practice address

103 Park Gate Ext
Tupelo, MS 38801-3038

Phone

(662) 842-2448

Fax

(662) 842-8374

NPI assigned

Aug 8, 2013

Last updated

Aug 8, 2013By 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

James Michael Robertson, DMDNPI 1750594412

Title

President

Phone

(662) 842-2448

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.

• James Michael Robertson, DMD

  • Periodontics
  • Tupelo, MS
  • NPI 1750594412
  Authorized official Same address or phone

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1932531373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PARK GATE EXT",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388013038",
            "telephone_number": "662-842-2448",
            "fax_number": "662-842-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PARK GATE EXT",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388013038",
            "telephone_number": "662-842-2448",
            "fax_number": "662-842-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MISSISSIPPI PERIODONTICS & IMPLANT DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-842-2448",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MS",
            "license": "2571-90",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Mississippi Medical Clinics, Inc. (Verona Medical Clinic)
• North Mississippi Oral & Maxillofacial Surgery Associates, PA
• North Mississippi Orthodontic Associates PA
• North Mississippi Pain Management Center
• North Mississippi Pediatrics PA
• North Mississippi State Hospital
• North Mississippi State Hospital Pharmacy
• North Mississippi Vascular Center, PA
• North Ms Emergency Physicians
• Northeast Community Services

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.