Southern Smile Studio

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOUTHERN SMILE STUDIO

Practice address

6155 Hwy 25
Suite 1a
Brandon, MS 39047

Phone

(769) 241-2141

NPI assigned

Oct 28, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Kellie McAdams Watts, DMDNPI 1578083671

Title

Dentist/Owner

Phone

(601) 594-8607

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.

• Kellie McAdams Watts, DMD

  • General Practice Dentistry
  • Ridgeland, MS
  • NPI 1578083671
  NPD Authorized official

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1992527287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 ANCHOR LANE",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39047",
            "telephone_number": "601-594-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6155 HWY 25",
            "address_2": "SUITE 1A",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39047",
            "telephone_number": "769-241-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SMILE STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "MCADAMS",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "601-594-8607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Brandon, MS
• Providers in Brandon, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.