Active NPI
Austin Rogers, DDS
- Dentist
- Ridgeland, MS
National Provider Identifier
1932830734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4300-22
- Practice address
- 401 West Jackson Street
Ridgeland, MS 39157 - Phone
- (601) 713-1923
- NPI assigned
- Jun 22, 2022
- Last updated
- Feb 20, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4300-22 | MS | Primary |
Addresses
Primary practice location
401 West Jackson Street
Ridgeland, MS 39157
Mailing address
401 W Jackson Street
Ridgeland, MS 39157
Phone (731) 695-1599
Other practice location 1
1149 Old Fannin Rd Ste 26
Brandon, MS 39047-9244
Phone (601) 992-7972
Other practice location 2
101 S Pearl St
Carthage, MS 39051-4110
Phone (601) 267-5111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4300-22 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reservoir Smiles Dentistry, PLLC | Past | Accepting new patients | |
| Hall Family Dentistry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Carthage, MS
- NPI 1942468202
-
- Dental Clinic/Center
- Brandon, MS
- NPI 1316458136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1932830734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 W JACKSON STREET",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "39157",
"telephone_number": "731-695-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 WEST JACKSON STREET",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "39157",
"telephone_number": "601-713-1923"
}
],
"practiceLocations": [
{
"address_1": "1149 Old Fannin Rd Ste 26",
"address_purpose": "LOCATION",
"city": "Brandon",
"state": "MS",
"postal_code": "390479244",
"country_code": "US",
"telephone_number": "601-992-7972",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "101 S Pearl St",
"address_purpose": "LOCATION",
"city": "Carthage",
"state": "MS",
"postal_code": "390514110",
"country_code": "US",
"telephone_number": "601-267-5111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROGERS",
"first_name": "AUSTIN",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-22",
"last_updated": "2024-02-20",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "4300-22",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.