DR. DEIDRA JANIECE SNELL D.M.D. NPI 1811150766

NPI Information

NPI: 1811150766
Provider Name: DR. DEIDRA JANIECE SNELL, D.M.D.
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
5800 RIDGEWOOD RD
SUITE 105
JACKSON, MS
ZIP 39211
Phone: (601) 398-2934
Get Directions

DR. Deidra Janiece Snell, D.M.D. is a general practice dentist in Jackson, MS. The provider is 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. DR. Deidra Janiece Snell, D.M.D. NPI is 1811150766. 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:

5800 RIDGEWOOD RD
SUITE 105
JACKSON, MS
ZIP 39211-667
Phone: (601) 398-2934
Fax: (769) 216-3311

The enumeration date for this NPI number is 7/9/2008 and was last updated on 10/11/2016.

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	390200000X	Student in an Organized Health Care Education/Training Program				No
2	1223G0001X	Dentist	General Practice	3459-08	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1811150766	MEDICAID	MISSISSIPPI

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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