VICKSBURG FAMILY DENTAL 61N (NPI# 1649626573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649626573 |
| Entity Type | Organization |
| Organization Name | VICKSBURG FAMILY DENTAL 61N |
| Practice Address |
1650 Highway 61 N Vicksburg MS 39183-3522 |
| Practice Telephone | 6016296066 |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |
| Authorized Official Name | DR. TERRY LAKE GARNER (OWNER) |
| Authorized Official Telephone | 6016296066 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
MS | Dental Providers |
| Street Address |
1650 HIGHWAY 61 N |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| Find all providers in zip 39183 | ||||
| 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 |
|---|---|---|---|---|
| 1982952115 | Jordan P Crocker | Dentist | 109 Monument Pl, Vicksburg, MS 39180-5161 | 2012-08-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1992910244 | Kurt R Schrock I | Dentist | 1903 Mission 66, Vicksburg, MS 39180-3711 | 2007-05-11 |
| 1649492695 | Charles Brent Thomas | Dentist | 1805 Mission 66, Vicksburg, MS 39180-3709 | 2007-05-02 |
| 1962523944 | Robert M Abraham, D.d.s., P.a. | Dentist | 1909 Mission 66, Vicksburg, MS 39180-3711 | 2007-04-03 |
| 1760500649 | Donald William Jackson | Dentist | 1909 A Mission 66, Vicksburg, MS 39180-3711 | 2007-03-27 |
| 1891812731 | Lemont Terrance Norris | Dentist | 1713 Clay St, Ste 5, Vicksburg, MS 39183-3048 | 2007-03-24 |
| 1366582413 | Robert A Sadler | Dentist | 1016 Mission 66, Vicksburg, MS 39183-2752 | 2007-02-07 |
| 1821150194 | Martin V Chaney | Dentist | 3205 Wisconsin Ave, Vicksburg, MS 39180-5350 | 2006-12-14 |
| 1740353408 | Ballard Dental Group | Dentist | 3040 Indiana Avenue, Vicksburg, MS 39180 | 2006-11-17 |
| Find all providers in VICKSBURG | ||||
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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.