DR. SUSAN COPE FORTENBERRY D.M.D. NPI 1083936132

NPI Information

NPI: 1083936132
Provider Name: DR. SUSAN COPE FORTENBERRY, D.M.D.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
5315 HIGHWAY 18 W
JACKSON, MS
ZIP 39209
Phone: (601) 922-0066
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DR. Susan Cope Fortenberry, D.M.D. is a pediatric dentistry dentist in Jackson, MS. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Susan Cope Fortenberry, D.M.D. NPI is 1083936132. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5315 HIGHWAY 18 W
JACKSON, MS
ZIP 39209-421
Phone: (601) 922-0066
Fax: (601) 922-0077

The enumeration date for this NPI number is 2/17/2010 and was last updated on 2/17/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	3429-07	MISSISSIPPI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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