COASTAL PEDIATRIC DENTISTRY, LLC (NPI# 1184167553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184167553 |
| Entity Type | Organization |
| Organization Name | COASTAL PEDIATRIC DENTISTRY, LLC |
| Practice Address |
1119 42nd Ave Gulfport MS 39501-2664 |
| Practice Telephone | 2288648521 |
| Mailing Telephone | 2288648521 |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2016-12-02 |
| Authorized Official Name | DR. EDWARD VICTOR BROWN III (OWNER) |
| Authorized Official Telephone | 5042371203 |
| Authorized Official Credential | DDS, MSD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
3502-09 | MS | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780736546 | Coastal Pediatric Dentistry, LLC | Dentist | 23 Main St, Suite 302, Hilton Head, SC 29926-1648 | 2007-01-18 |
| Street Address |
1119 42ND AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790851707 | Raymond Kimble Doty Jr. | Dentist | 1119 42nd Ave, Gulfport, MS 39501-2664 | 2006-11-28 |
| 1730255753 | R Kimble Doty, Jr Dds,ms Pediatric Dentistry, PC | Clinic/Center | 1119 42nd Ave, Gulfport, MS 39501-2664 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124288501 | Coastal Family Health Center | Clinic/Center | 15024 Martin Luther King Jr Blvd, Gulfport, MS 39501-8306 | 2008-06-10 |
| 1730255753 | R Kimble Doty, Jr Dds,ms Pediatric Dentistry, PC | Clinic/Center | 1119 42nd Ave, Gulfport, MS 39501-2664 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144838970 | Superior Smiles, LLC | Clinic/Center | 16690 E Main St, Louisville, MS 39339-2750 | 2020-07-17 |
| 1255991196 | Sky Family Dental, LLC | Clinic/Center | 200 Meadowlane Street, Eupora, MS 39744 | 2019-06-13 |
| 1851886857 | Grenada Dental Clinic Pllc | Clinic/Center | 1800 Hill Dr Ste A, Grenada, MS 38901-5071 | 2018-06-22 |
| 1467940627 | Ld-columbus LLC | Clinic/Center | 611 Leigh Dr, Columbus, MS 39705-3036 | 2018-04-24 |
| 1821592734 | Integrity Dental Clinic, Pllc | Clinic/Center | 201 E Layfair Dr Ste 100, Flowood, MS 39232-7604 | 2018-03-23 |
| 1336647924 | Murphree's Smile Designers | Clinic/Center | 602 Pegram Dr, Tupelo, MS 38801-6322 | 2018-01-29 |
| 1144735481 | Peoples Dental Pa | Clinic/Center | 1016 Louisville St Ste G, Starkville, MS 39759-3953 | 2017-12-08 |
| 1366956419 | Bradley M Stewart Dmd LLC | Clinic/Center | 6855 Crumpler Blvd Ste 100, Olive Branch, MS 38654-1930 | 2017-11-28 |
| 1316458136 | Reservoir Smiles Dentistry, Pllc | Clinic/Center | 1149 Old Fannin Rd Ste 26, Brandon, MS 39047-9244 | 2017-10-19 |
| 1356851752 | Oakdale Family Dentistry | Clinic/Center | 2139 Hwy 471, Flowood, MS 39232 | 2017-10-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.