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SOUTH MAIN DENTAL
NPI 1043756687
Dentist - General Practice in Pontotoc, MS

Active since January 06, 2017
209 S MAIN ST, PONTOTOC, MS 38863(662) 489-7768(662) 489-8256 Get Directions Write a Review

NPPES record last updated: January 6, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About South Main Dental NPPES

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

SOUTH MAIN DENTAL (NPI 1043756687) is a healthcare organization registered as a general practice in Pontotoc, Mississippi and active in the NPI registry since January 2017. The organization lists John Thomas Black, Manager, as its authorized official.

NPPES Registry Identity

NPI1043756687
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTH MAIN DENTAL CLINIC, LLC
Location Address209 S MAIN STPontotoc, MS 38863-3319
Mailing Address209 S Main StPontotoc, MS 38863-3319 · (662) 489-7768 · Fax (662) 489-8256
Phone(662) 489-7768
Fax(662) 489-8256
Organization SubpartNo
Authorized OfficialJohn Thomas BlackManager · (662) 489-7768
Enumeration DateJanuary 6, 2017
✔ NPI 1043756687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MS · 2066-84
Definition
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.
209 S MAIN ST, Pontotoc, MS 38863
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Other Names 1

Doing Business AsSouth Main Dental

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 4

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

DR. MATTHEW CARTER CLAYTON DMD
Dentist (General Practice)
209 S MAIN ST
PONTOTOC, MS 38863
Pontotoc County (662) 586-2311
CLAYTON FAMILY DENTISTRY, PLLC
Dentist (General Practice)
209 S MAIN ST
PONTOTOC, MS 38863
Pontotoc County (662) 586-2311
DR. JOHN THOMAS BLACK JR. D.M.D.
Dentist (General Practice)
209 S MAIN ST
PONTOTOC, MS 38863
Pontotoc County (662) 489-7768
DR. ANNA GRACE CLAYTON DMD
Dentist (General Practice)
209 S MAIN ST
PONTOTOC, MS 38863
Pontotoc County (662) 586-2311

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 South Main Dental Clinic, LLC's NPI number?

The NPI number for South Main Dental Clinic, LLC is 1043756687. It was assigned to this organization in the NPPES registry on January 6, 2017. The provider is doing business as South Main Dental.

Where is South Main Dental Clinic, LLC located?

South Main Dental Clinic, LLC is located at 209 S Main St, Pontotoc, MS 38863. The listed phone number is (662) 489-7768.

What is South Main Dental Clinic, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for South Main Dental Clinic, LLC was last updated on January 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.