KS2 MS PC (NPI# 1689864662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689864662 |
| Entity Type | Organization |
| Organization Name | KS2 MS PC |
| Other Organization Name | SUNNYBROOK DENTISTRY |
| Practice Address |
989 Ellis Ave Jackson MS 39209-6256 |
| 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 | 2007-07-26 |
| Last Update Date | 2019-01-10 |
| Authorized Official Name | DR. 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 |
| 1518166214 | Ks2 Ms PC | Dentist | 3720 Hardy St, Suite 23, Hattiesburg, MS 39402-1550 | 2007-07-12 |
| Street Address |
989 ELLIS AVE |
| City | JACKSON |
| State | MS |
| Zip Code | 39209-6256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649210477 | Melanie Paige-brown | Dentist | 989 Ellis Ave, Jackson, MS 39209-6256 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| Find all providers in zip 39209 | ||||
| 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 |
|---|---|---|---|---|
| 1518584952 | Katherine Olivia Hughes | Dentist | 1189 Vann Dr, Jackson, TN 38305-6098 | 2020-07-01 |
| 1144845991 | Gregory Derrick Meredith | Dentist | 190 Water St Ste 2, Jackson, OH 45640-1384 | 2020-06-08 |
| 1033771852 | Robert E Scheddin | Dentist | 2046 W County Line Rd Ste 2, Jackson, NJ 08527-2034 | 2019-07-01 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1780145912 | Dr Lashawn Steptoe Family Dentistry | Dentist | 500 E Woodrow Wilson Ave Ste N, Jackson, MS 39216-4538 | 2019-03-29 |
| 1720571334 | Christina Holy Mcrae | Dentist | 3000 Old Canton Rd Ste 515, Jackson, MS 39216-4235 | 2018-06-08 |
| 1275024192 | Brianne Elizabeth Mezo | Dentist | 1500 W Parnall Rd, Jackson, MI 49201-8660 | 2018-05-26 |
| 1407343254 | West Tennessee Dentistry Pllc | Dentist | 1108 Whitehall St, Jackson, TN 38301-3730 | 2018-04-17 |
| 1073014338 | Helping Hands of Middle & West Tennessee | Dentist | 1408 N Highland Ave Ste 101, Jackson, TN 38301-3450 | 2018-02-22 |
| 1942730429 | Patrice Nicole Griffith | Dentist | 1189 E County Line Rd Ste 1010, Jackson, MS 39211-1836 | 2017-06-15 |
| 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.