EAST MISSISSIPPI ORAL & FACIAL SURGERY, LLC (NPI# 1235508342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235508342 |
| Entity Type | Organization |
| Organization Name | EAST MISSISSIPPI ORAL & FACIAL SURGERY, LLC |
| Practice Address |
1212 24th Avenue Meridian MS 39301 |
| Practice Telephone | 6012865240 |
| Mailing Telephone | 6012865240 |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2016-03-18 |
| Authorized Official Name | ASIF A LALA (OWNER) |
| Authorized Official Telephone | 9126758468 |
| Authorized Official Credential | DMD, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
3785-15 | MS | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407203268 | East Mississippi Oral & Facial Surgery, LLC | Dentist | 1903 23rd Ave, Meridian, MS 39301-3108 | 2016-05-20 |
| Street Address |
1212 24TH AVENUE |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| 1326443938 | Ophelia Mayfield | Counselor | 1923 23rd Ave., Meridian, MS 39301 | 2014-10-24 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841634581 | Oral Surgery Center of Idaho, Pllc | Clinic/Center | 1550 N Crestmont Dr Ste G, Meridian, ID 83642-2177 | 2013-04-24 |
| 1346572435 | G. Pete Leseberg D.m.d.,p.a. | Clinic/Center | 1550 N Crestmont Dr, Ste G, Meridian, ID 83642-2184 | 2010-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851543250 | Oral and Facial Surgery of Mississippi | Clinic/Center | 266 Katherine Dr, Flowood, MS 39232-8801 | 2008-10-16 |
Please comment or provide details below to improve the information on EAST MISSISSIPPI ORAL & FACIAL SURGERY, LLC.
| 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.