Jeremy Drew King, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

339006 Issued in MS

Practice address

1381 Johnny Johnson Drive
Brookhaven, MS 39601-9641

Phone

(601) 823-2990

Fax

(601) 823-2991

NPI assigned

Mar 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Brookhaven Smile Center, Inc

  • General Practice Dentistry
  • Brookhaven, MS
  • NPI 1922203306
  NPD (past) Authorized official

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982728580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 JOHNNY JOHNSON DRIVE",
            "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 DRIVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396019641",
            "telephone_number": "601-823-2990",
            "fax_number": "601-823-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JEREMY",
        "middle_name": "DREW",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "339006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kembe Keys
• Holly L Kimbrell, CFNP
• Sarah Kathryn Kimes
• Kindness Healthcare Services LLC
• Jaci King
• Theresa Renee King, RN, CFNP
• King's Daughters Medial Center
• King's Daughters Medial Center
• King's Daughters Medical Center (King's Daughters Primary Care Clinic)
• King's Daughters Medical Center (King's Daughters Medical Clinic)

• 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 Jul 8, 2007; 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.