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PEDIATRIC DENTISTRY, P.A.
NPI 1134414733
Dentist - Pediatric Dentistry in Jackson, MS

Active since June 13, 2011
5315 HIGHWAY 18 W, JACKSON, MS 39209(601) 922-0066(601) 922-0077 Get Directions Write a Review

NPPES record last updated: June 13, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric Dentistry, P.a. NPPES

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

PEDIATRIC DENTISTRY, P.A. (NPI 1134414733) is a healthcare organization registered as a pediatric dentistry in Jackson, Mississippi and active in the NPI registry since June 2011. The organization lists L Lee Cope, Dentist, as its authorized official.

NPPES Registry Identity

NPI1134414733
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePEDIATRIC DENTISTRY, P.A.
Location Address5315 HIGHWAY 18 WJackson, MS 39209-9421
Mailing Address5315 Highway 18 WJackson, MS 39209-9421 · (601) 922-0066 · Fax (601) 922-0077
Phone(601) 922-0066
Fax(601) 922-0077
Organization SubpartNo
Authorized OfficialL Lee CopeDentist · (601) 922-0066
Enumeration DateJune 13, 2011
✔ NPI 1134414733 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 · 1865-80
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.
5315 HIGHWAY 18 W, Jackson, MS 39209
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Other Identifiers 1

Medicaid00064746MS

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.

DR. SUSAN COPE FORTENBERRY D.M.D.
Dentist (Pediatric Dentistry)
5315 HIGHWAY 18 W
JACKSON, MS 39209
Hinds County (601) 922-0066
DR. MARTHA MANGUM HOLLAND D.M.D.
Dentist (Pediatric Dentistry)
5315 HIGHWAY 18 W
JACKSON, MS 39209
Hinds County (601) 922-0066

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 Pediatric Dentistry, P.A.'s NPI number?

The NPI number for Pediatric Dentistry, P.A. is 1134414733. It was assigned to this organization in the NPPES registry on June 13, 2011.

Where is Pediatric Dentistry, P.A. located?

Pediatric Dentistry, P.A. is located at 5315 Highway 18 W, Jackson, MS 39209. The listed phone number is (601) 922-0066.

What is Pediatric Dentistry, P.A.'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 Pediatric Dentistry, P.A. was last updated on June 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.