LIFETIME DENTAL PLLC NPI 1053573725

NPI Information

  • NPI: 1053573725
  • Provider Name: LIFETIME DENTAL PLLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Former Legal Business Name: JOHNSON DENTAL CLINIC
  • Address: 1313 W HIGHWAY 8
    CLEVELAND, MS
    ZIP 38732
  • Phone: (662) 843-8353

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NPI Details

LIFETIME DENTAL PLLC is a general practice dentist in Cleveland, 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. LIFETIME DENTAL PLLC NPI is 1053573725. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Johnson Dental Clinic.

The provider's business location address is:

1313 W HIGHWAY 8
CLEVELAND, MS
ZIP 38732-240
Phone: (662) 843-8353
Fax: (662) 843-8363

The provider's authorized official is Hamilton M Brown .
The authorized official title is Partner and has the following contact phone number (662) 843-8353.

The enumeration date for this NPI number is 6/25/2008 and was last updated on 11/23/2022.

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
11223G0001XDentistGeneral Practice2826-94MISSISSIPPIYes

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
109015931MEDICAIDMISSISSIPPI

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: 3/30/2025

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