COASTAL PEDIATRIC DENTISTRY LLC NPI 1184167553

NPI Information

NPI: 1184167553
Provider Name: COASTAL PEDIATRIC DENTISTRY, LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1119 42ND AVE
GULFPORT, MS
ZIP 39501
Phone: (228) 864-8521
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COASTAL PEDIATRIC DENTISTRY, LLC is a dental clinic center in Gulfport, MS. COASTAL PEDIATRIC DENTISTRY, LLC NPI is 1184167553. The provider is registered as an organization entity type.

The provider's business location address is:

1119 42ND AVE
GULFPORT, MS
ZIP 39501-664
Phone: (228) 864-8521

The provider's authorized official is Edward Victor Brown .
The authorized official title is Owner and has the following contact phone number (504) 237-1203.

The enumeration date for this NPI number is 12/2/2016 and was last updated on 12/2/2016.

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	261QD0000X	Clinic/Center	Dental	3502-09	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: 4/28/2024

NPI Synchronization or Removal

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