PREMIER DENTAL (NPI# 1760995963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760995963 |
| Entity Type | Organization |
| Organization Name | PREMIER DENTAL |
| Practice Address |
1763 Cliff Gookin Blvd Tupelo MS 38801-6723 |
| Mailing Address |
Po Box 1156 Oxford MS 38655-1156 |
| Practice Telephone | 6628422802 |
| Mailing Telephone | 6628422802 |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2018-04-12 |
| Authorized Official Name | MS. SHAWNA M REYNOLDS (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6627104244 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFE DENTAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
282594 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 1588867337 | 05 | |
| MS | 1427264241 | 05 | |
| MS | 1023468659 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104103548 | Premier Dental | Dentist | 39 Waco Dr, London, KY 40741-8327 | 2011-11-14 |
| 1881844439 | Premier Dental | Dentist | 102 W Main, Haskell, OK 74436 | 2008-09-19 |
| 1720160039 | Premier Dental | Dentist | 17791 Oh- 31, Marysville, OH 43040 | 2006-10-19 |
| 1427398411 | Premier Dental | Dentist | 1514 White Bear Ave N, B, Saint Paul, MN 55106-1624 | 2013-02-27 |
| 1942597190 | Premier Dental | Dentist | 15892 Pasadena Ave, Tustin, CA 92780-5415 | 2011-07-07 |
| 1871750422 | Premier Dental | Dentist | 5511 Edmondson Pike, Suite 201, Nashville, TN 37211 | 2008-05-21 |
| 1821280272 | Premier Dental | Dentist | 390 Vineyard Way, Suite 505, West Grove, PA 19390-8835 | 2007-08-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Premier Dental Accounting, Inc. | 18924 E Berry Drive, Aurora, CO 80015 |
| North Carolina Corporations | Premier Dental Assisting Academy L.L.C. | 6708 Regal Oaks Drive, Charlotte, NC 28212-3834 |
| Indiana Business Entities | PREMIER DENTAL CARE | 6920 S. East Street, Suite A, Indianapolis, IN 46227 |
| Ohio Business Entities | PREMIER DENTAL CARE OF COLUMBUS-DR. SABITHA PARASA | 4039 Laurel Valley Drive, Powell, OH 43065 |
| Virginia Business Entities | PREMIER DENTAL CARE P.C. | 2579 John Milton Dr, Ste 250, Oak Hill, Virginia 20171 |
| Massachusetts Corporations | PREMIER DENTAL CONCEPTS OF ANDOVER, INC. | 351 North Main Street, Andover, Massachusetts, MA 01810 |
| Colorado Business Entities | Premier Dental Consulting, LLC | 11543 W 16th Ave, Lakewood, CO 80215 |
| Oregon Corporations, Companies and Business Names | PREMIER DENTAL GROUP OF AMERICA, LLC | 808 Se Oak St, Hillsboro, OR 97123 |
| Virginia Business Entities | Premier Dental Group PLLC | 7529 Old Dominion Dr, Mclean, Virginia 22102 |
| Colorado Business Entities | Premier Dental Health at Eagle Bend Corp. | 22651 E. Aurora Pkwy, Suite A5, Aurora, CO 80016 |
| Street Address |
1763 CLIFF GOOKIN BLVD |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427264241 | John T Lamberth | Dentist | 1763 Cliff Gookin Blvd, Tupelo, MS 38801-6723 | 2007-05-16 |
| 1982263380 | Kyle Winston Tubb | Dentist | 1763 Cliff Gookin Blvd, Tupelo, MS 38801-6723 | 2019-06-10 |
| 1578083671 | Kellie Mcadams Watts | Dentist | 1763 Cliff Gookin Blvd, Tupelo, MS 38801-6723 | 2017-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336647924 | Murphree's Smile Designers | Clinic/Center | 602 Pegram Dr, Tupelo, MS 38801-6322 | 2018-01-29 |
| 1528280880 | Kellum Dental Clinic | Clinic/Center | 505 Robins St, Tupelo, MS 38804-3715 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144838970 | Superior Smiles, LLC | Clinic/Center | 16690 E Main St, Louisville, MS 39339-2750 | 2020-07-17 |
| 1255991196 | Sky Family Dental, LLC | Clinic/Center | 200 Meadowlane Street, Eupora, MS 39744 | 2019-06-13 |
| 1851886857 | Grenada Dental Clinic Pllc | Clinic/Center | 1800 Hill Dr Ste A, Grenada, MS 38901-5071 | 2018-06-22 |
| 1467940627 | Ld-columbus LLC | Clinic/Center | 611 Leigh Dr, Columbus, MS 39705-3036 | 2018-04-24 |
| 1821592734 | Integrity Dental Clinic, Pllc | Clinic/Center | 201 E Layfair Dr Ste 100, Flowood, MS 39232-7604 | 2018-03-23 |
| 1144735481 | Peoples Dental Pa | Clinic/Center | 1016 Louisville St Ste G, Starkville, MS 39759-3953 | 2017-12-08 |
| 1366956419 | Bradley M Stewart Dmd LLC | Clinic/Center | 6855 Crumpler Blvd Ste 100, Olive Branch, MS 38654-1930 | 2017-11-28 |
| 1316458136 | Reservoir Smiles Dentistry, Pllc | Clinic/Center | 1149 Old Fannin Rd Ste 26, Brandon, MS 39047-9244 | 2017-10-19 |
| 1356851752 | Oakdale Family Dentistry | Clinic/Center | 2139 Hwy 471, Flowood, MS 39232 | 2017-10-11 |
| 1073985925 | Decatur Dental, LLC | Clinic/Center | 68 Fourth Ave, Decatur, MS 39327-9713 | 2015-10-30 |
| Find all providers with the same taxonomy | ||||
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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.