KS2 MS PC (NPI# 1518166214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518166214 |
| Entity Type | Organization |
| Organization Name | KS2 MS PC |
| Other Organization Name | SUNNYBROOK DENTISTRY |
| Practice Address |
3720 Hardy St Suite 23 Hattiesburg MS 39402-1550 |
| Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
| Practice Telephone | 6789045665 |
| Practice Fax Number | 6789045666 |
| Mailing Telephone | 7709165028 |
| Mailing Fax Number | 6782477858 |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2019-01-07 |
| Authorized Official Name | DALE G MAYFIELD (PRESIDENT) |
| Authorized Official Telephone | 7709165036 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Kool Smiles | Doing Business As Name - Organization |
| Sunnybrook Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528258464 | Ks2 Ms PC | Dentist | 401 S Gloster St, Suite 101, Tupelo, MS 38801-5539 | 2007-07-26 |
| 1689864662 | Ks2 Ms PC | Dentist | 989 Ellis Ave, Jackson, MS 39209-6256 | 2007-07-26 |
| Street Address |
3720 HARDY ST SUITE 23 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-1550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417009382 | Kineshia Abram Roark | Dentist | 3720 Hardy St, Hattiesburg, MS 39402-1550 | 2007-01-18 |
| 1780947127 | Erica Mcinnis Rose | Dentist | 3720 Hardy St, Hattiesburg, MS 39402-1550 | 2012-06-20 |
| 1992067664 | Amy Gardner Sutton | Dentist | 3720 Hardy St, Suite 23, Hattiesburg, MS 39402-1550 | 2012-06-08 |
| 1114138971 | David M Moore | Dentist | 3720 Hardy St, St 23, Hattiesburg, MS 39402-1550 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1588140610 | Amadia J Giles | Dentist | 6668 U S Highway 98 Ste G, Hattiesburg, MS 39402-7982 | 2018-07-11 |
| 1780176677 | Samuel Eric Johnson | Dentist | 5128 Old Highway 11 Ste 7, Hattiesburg, MS 39402-6234 | 2018-06-05 |
| 1093234684 | John Davis | Dentist | 7100 Highway 98, Suite 210, Hattiesburg, MS 39402-8601 | 2017-09-14 |
| 1194166017 | Zachariah Lea Crawford | Dentist | 47 E Lake Rd, Hattiesburg, MS 39402-7706 | 2013-07-08 |
| 1154760510 | Bluebonnet Dental Care Hattiesburg LLC | Dentist | 6668 Hwy 98 West Ste G, Hattiesburg, MS 39402 | 2013-06-19 |
| 1285999367 | Elise Burton Graham | Dentist | 4301 Lincoln Rd, Suite 10, Hattiesburg, MS 39402-3036 | 2012-07-05 |
| 1215251673 | Barnes Family Dentistry | Dentist | 5910 Highway 49, Ste 15, Hattiesburg, MS 39401-7585 | 2010-03-15 |
| 1154561728 | Lake Serene Family Dental Clinic | Dentist | 6668 U S Highway 98, Ste. G, Hattiesburg, MS 39402-7981 | 2009-02-23 |
| 1508014176 | Felder E Wallace | Dentist | 6194 Hwy 98 West, Hattiesburg, MS 39402 | 2008-09-08 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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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.