MAXILLOFACIAL SURGERY CENTER OF CENTRAL MISSISSIPPI (NPI# 1609960749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609960749 |
| Entity Type | Organization |
| Organization Name | MAXILLOFACIAL SURGERY CENTER OF CENTRAL MISSISSIPPI |
| Practice Address |
266 Katherine Dr Jackson MS 39232-8801 |
| Practice Telephone | 6014203223 |
| Practice Fax Number | 6014203054 |
| Mailing Telephone | 6014203223 |
| Mailing Fax Number | 6014203054 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. J JOEL DRUMMOND (CO-OWNER) |
| Authorized Official Telephone | 6014203223 |
| Authorized Official Credential | D.M.D., M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3119.00 | MS | Dental Providers |
| X | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2820.94 | MS | Dental Providers |
| X | 174400000X | Specialist | 05.339.00 | MS | Other Service Providers |
| X | 174400000X | Specialist | 05.340.00 | MS | Other Service Providers |
| X | 174400000X | Specialist | 16843 | MS | Other Service Providers |
| X | 174400000X | Specialist | 16896 | MS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00123549 | 05 | |
| MS | 00123548 | 05 |
| Street Address |
266 KATHERINE DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39232-8801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427189224 | Michael R Nichols | Dentist | 266 Katherine Dr, Jackson, MS 39232-8801 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164071775 | Leanna Nicole Howard | Social Worker | 2945 Layfair Drive, Apt. 1621, Flowood, MS 39232 | 2019-09-06 |
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1285101816 | Magnolia Anesthesia Consultants LLC | Anesthesiology | 4209 Lakeland Dr #252, Flowood, MS 39232 | 2018-11-01 |
| 1528543592 | Matthew T Armstrong | Physical Therapist | 104 Burney Drive, Flowood, MS 39232 | 2018-09-26 |
| 1790265627 | Mississippi Brain and Spine, Pllc | Non-Pharmacy Dispensing Site | 1 Layfair Drive, Ste 120, Flowood, MS 39232 | 2018-08-20 |
| 1629574918 | Billy Clifton Osbon Jr. | Pharmacist | 2506 Lakeland Drive, Suite 201, Flowood, MS 39232 | 2018-04-04 |
| 1356851752 | Oakdale Family Dentistry | Clinic/Center | 2139 Hwy 471, Flowood, MS 39232 | 2017-10-11 |
| 1992227177 | Charisma T. Cummings | Nurse Practitioner | 102 Riverview Drive, Suite A, Flowood, MS 39232 | 2017-07-10 |
| 1508398983 | Charles Pearson | Student in an Organized Health Care Education/Training Program | 764 Flowood Dr, Flowood, MS 39232 | 2017-04-03 |
| 1396288197 | Mary Claire Ponder | Nurse Practitioner | 151 E Metro Dr Ste 103, Flowood, MS 39232 | 2016-11-28 |
| Find all providers in zip 39232 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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 |
|---|---|---|---|---|
| 1639792450 | Dr Riley PC | Dentist | 1325 S Hwy 89 Apt 105, Jackson, WY 83001-8293 | 2020-05-27 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1083852149 | Michael Stern | Dentist | 1160 Alpine Ln, Suite 1d, Jackson, WY 83001 | 2009-01-28 |
| 1144481961 | Nathan James Ostler | Dentist | 688 Brewers Bridge Rd, Jackson, NJ 08527-2017 | 2008-06-24 |
| 1437370988 | Kyle Tanner Hunt | Dentist | 971 Lakeland Dr Ste 952, Jackson, MS 39216-4609 | 2007-05-01 |
| 1215009980 | Rodney Arnell Hunt | Dentist | 971 Lakeland Dr Ste 600, Jackson, MS 39216-4608 | 2006-11-15 |
| 1225123078 | Cynthia A Rider | Dentist | 2545 Spring Arbor Rd., Suite 202, Jackson, MI 49203 | 2006-10-04 |
| 1134224116 | Jerry B Booth | Dentist | 683 Robinson Rd, Jackson, MI 49203-1155 | 2006-09-14 |
| 1164430971 | Teton Oral & Maxillofacial Surgery | Dentist | 1160 Alpine Lane, #1d, Jackson, WY 83002 | 2006-08-04 |
| 1497732861 | John Walton Crowder | Dentist | 39 Murray Guard Dr, Jackson, TN 38305-3610 | 2005-12-28 |
| Find all providers in JACKSON | ||||
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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.