MAIN STREET DENTAL
NPI 1043557085
Dentist in Southaven, MS

Q: What is Main Street Dental's NPI number?

The NPI number for Main Street Dental is 1043557085. It was assigned to this organization in the NPPES registry on January 10, 2013. The provider was formerly known as Drs. Joe Braddy & Simmons.

Q: What is Main Street Dental's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since January 10, 2013

8747 NORTHWEST DR, SOUTHAVEN, MS 38671(662) 393-0781(662) 342-0750 Get Directions Write a Review

NPPES record last updated: January 28, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 28, 2016, Dec 2, 2015 (2 updates tracked since 2015).

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About Main Street Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAIN STREET DENTAL (NPI 1043557085), doing business as Drs. Joe Braddy & Simmons, is a healthcare organization registered as a dentist in Southaven, Mississippi and active in the NPI registry since January 2013. The organization lists Jarad Braddy, Member, as its authorized official.

NPPES Registry Identity

NPI1043557085

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameMAIN STREET DENTAL

Location Address8747 NORTHWEST DRSouthaven, MS 38671-2409

Mailing Address8747 Northwest DrSouthaven, MS 38671-2409 · (662) 393-0781 · Fax (662) 342-0750

Phone(662) 393-0781

Fax(662) 342-0750

Organization SubpartNo

Authorized OfficialJarad BraddyMember · (662) 393-0781

Enumeration DateJanuary 10, 2013

Last NPPES UpdateJanuary 28, 20162 updates tracked since enumeration

✔ NPI 1043557085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MS · 3341-05

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

8747 NORTHWEST DR, Southaven, MS 38671

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Other Names 1

Former Legal Business NameDrs. Joe Braddy & Simmons

Other Identifiers 1

Medicaid082288765MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.

Dentist (General Practice)

8747 NORTHWEST DR
SOUTHAVEN, MS 38671

Desoto County (662) 393-0781

JARAD JOSEPH BRADDY D.D.S.

Dentist (General Practice)

8747 NORTHWEST DR
SOUTHAVEN, MS 38671

Desoto County (662) 393-0781

DANIEL RHETT SIMMONS D.M.D.

Dentist (General Practice)

8747 NORTHWEST DR
SOUTHAVEN, MS 38671

Desoto County (662) 393-0781

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Main Street Dental's NPI number?

The NPI number for Main Street Dental is 1043557085. It was assigned to this organization in the NPPES registry on January 10, 2013. The provider was formerly known as Drs. Joe Braddy & Simmons.

Where is Main Street Dental located?

Main Street Dental is located at 8747 Northwest Dr, Southaven, MS 38671. The listed phone number is (662) 393-0781.

What is Main Street Dental's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Main Street Dental was last updated on January 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.