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
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5800 RIDGEWOOD RD
    SUITE 105
    JACKSON, MS
    ZIP 39211
  • Phone: (601) 398-2934

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NPI Details

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 NPI 1811150766 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

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
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
21223G0001XDentistGeneral Practice3459-08MISSISSIPPIYes

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
11811150766MEDICAIDMISSISSIPPI

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: 11/21/2025

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