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COASTKIDS PEDIATRIC DENTISTRY, PLLC
NPI 1093262974
Dentist - Pediatric Dentistry in Gulfport, MS

Active since September 08, 2016
1635 E PASS RD, GULFPORT, MS 39507(228) 896-5197 Get Directions Write a Review

NPPES record last updated: September 8, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Coastkids Pediatric Dentistry, Pllc NPPES

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

COASTKIDS PEDIATRIC DENTISTRY, PLLC (NPI 1093262974) is a healthcare organization registered as a pediatric dentistry in Gulfport, Mississippi and active in the NPI registry since September 2016. The organization lists Lanette L Henry, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1093262974
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameCOASTKIDS PEDIATRIC DENTISTRY, PLLC
Location Address1635 E PASS RDGulfport, MS 39507-3527
Mailing Address1635 E Pass RdGulfport, MS 39507-3527 · (228) 896-5197
Phone(228) 896-5197
Organization SubpartNo
Authorized OfficialLanette L HenryOffice Administrator · (228) 896-5197
Enumeration DateSeptember 8, 2016
✔ NPI 1093262974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in MS · 2005-83
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
1635 E PASS RD, Gulfport, MS 39507
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Other Identifiers 2

Medicaid07734393MS
Medicaid05579706MS

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 2

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

REGGIE H. BROOM, D.M.D., P.A.
Dentist (Pediatric Dentistry)
1635 E PASS RD
GULFPORT, MS 39507
Harrison County (228) 896-5197
DR. KRISTEN MULLINS DOUGLAS DMD
Dentist (Pediatric Dentistry)
1635 E PASS RD
GULFPORT, MS 39507
Harrison County (228) 896-5197

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 Coastkids Pediatric Dentistry, PLLC's NPI number?

The NPI number for Coastkids Pediatric Dentistry, PLLC is 1093262974. It was assigned to this organization in the NPPES registry on September 8, 2016.

Where is Coastkids Pediatric Dentistry, PLLC located?

Coastkids Pediatric Dentistry, PLLC is located at 1635 E Pass Rd, Gulfport, MS 39507. The listed phone number is (228) 896-5197.

What is Coastkids Pediatric Dentistry, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Coastkids Pediatric Dentistry, PLLC was last updated on September 8, 2016. 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.