KELLUM DENTAL CLINIC NPI 1528280880

NPI Information

NPI: 1528280880
Provider Name: KELLUM DENTAL CLINIC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
505 ROBINS ST
TUPELO, MS
ZIP 38804
Phone: (662) 842-5080
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KELLUM DENTAL CLINIC is a dental clinic center in Tupelo, MS. KELLUM DENTAL CLINIC NPI is 1528280880. The provider is registered as an organization entity type.

The provider's business location address is:

505 ROBINS ST
TUPELO, MS
ZIP 38804-715
Phone: (662) 842-5080
Fax: (662) 842-5896

The provider's authorized official is Shaundi B. Little .
The authorized official title is Office Manager and has the following contact phone number (662) 842-5080.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 8/22/2020.

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	2554-90	MISSISSIPPI	No
2	261QD0000X	Clinic/Center	Dental	1782-77	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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