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MEDICAL ARTS DENTAL NORTH JACKSON NPI 1841565538


NPI Information

NPI: 1841565538
Provider Name: MEDICAL ARTS DENTAL NORTH JACKSON
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
4801 OLD CANTON RD
JACKSON, MS
ZIP 39211
Phone: (601) 948-2073
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MEDICAL ARTS DENTAL NORTH JACKSON 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. MEDICAL ARTS DENTAL NORTH JACKSON NPI is 1841565538. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4801 OLD CANTON RD
JACKSON, MS
ZIP 39211-522
Phone: (601) 948-2073
Fax: (601) 354-8773

The provider's authorized official is Robert J Neely .
The authorized official title is Dentist/owner and has the following contact phone number (601) 948-2073.

The enumeration date for this NPI number is 3/14/2012 and was last updated on 3/14/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice228886MISSISSIPPIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104831314MEDICAIDMISSISSIPPI

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

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