MERIDIAN PEDIATRIC DENTAL GROUP, LLC
NPI 1356606511
Dentist - Pediatric Dentistry in Meridian, MS

Active since July 12, 2012
1922 23RD AVE, MERIDIAN, MS 39301(601) 482-8986(601) 482-6100 Get Directions Write a Review

NPPES record last updated: July 12, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Meridian Pediatric Dental Group, Llc NPPES

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

MERIDIAN PEDIATRIC DENTAL GROUP, LLC (NPI 1356606511) is a healthcare organization registered as a pediatric dentistry in Meridian, Mississippi and active in the NPI registry since July 2012. The organization lists Shelley Wilkerson Ellis, Pediatric Dentist, as its authorized official.

NPPES Registry Identity

NPI1356606511
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameMERIDIAN PEDIATRIC DENTAL GROUP, LLC
Location Address1922 23RD AVEMeridian, MS 39301
Mailing Address1922 23rd AveMeridian, MS 39301 · (601) 482-8986 · Fax (601) 482-6100
Fax(601) 482-6100
Organization SubpartNo
Authorized OfficialShelley Wilkerson EllisPediatric Dentist · (601) 482-8986
Enumeration DateJuly 12, 2012
NPI 1356606511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
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.

1922 23RD AVE, Meridian, MS 39301

Other Identifiers 2

Medicaid00060313MS
Other01035561MS · Swe

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 MULTIPLE 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.

Dentist (Pediatric Dentistry)
1922 23RD AVE
MERIDIAN, MS 39301
Clinic/Center (Dental)
1922 23RD AVE
MERIDIAN, MS 39301
Dentist (Pediatric Dentistry)
1922 23RD AVE
MERIDIAN, MS 39301

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 Meridian Pediatric Dental Group, LLC's NPI number?

The NPI number for Meridian Pediatric Dental Group, LLC is 1356606511. It was assigned to this organization in the NPPES registry on July 12, 2012.

Where is Meridian Pediatric Dental Group, LLC located?

Meridian Pediatric Dental Group, LLC is located at 1922 23rd Ave, Meridian, MS 39301. The listed phone number is (601) 482-8986.

What is Meridian Pediatric Dental Group, LLC'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 Meridian Pediatric Dental Group, LLC was last updated on July 12, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.