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DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
NPI 1518791292
Dentist - General Practice in Southaven, MS

Active since August 27, 2024
8747 NORTHWEST DR, SOUTHAVEN, MS 38671(662) 393-0781 Get Directions Write a Review

NPPES record last updated: August 27, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Dental Professionals Of Mississippi, P.c. NPPES

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

DENTAL PROFESSIONALS OF MISSISSIPPI, P.C. (NPI 1518791292), doing business as Main Street Dental, is a healthcare organization registered as a general practice in Southaven, Mississippi and active in the NPI registry since August 2024. The organization lists Hillary Thull, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1518791292
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Location Address8747 NORTHWEST DRSouthaven, MS 38671-2409
Mailing Address8747 Northwest DrSouthaven, MS 38671-2409
Phone(662) 393-0781
Organization SubpartYesParent: Heartland Dental
Authorized OfficialHillary ThullCredentialing Coordinator · (217) 540-8946
Enumeration DateAugust 27, 2024
NPPES CertifiedAugust 27, 2024
✔ NPI 1518791292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
8747 NORTHWEST DR, Southaven, MS 38671
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Other Names 1

Doing Business AsMain Street 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 3

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

MAIN STREET DENTAL
Dentist
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 Dental Professionals Of Mississippi, P.C.'s NPI number?

The NPI number for Dental Professionals Of Mississippi, P.C. is 1518791292. It was assigned to this organization in the NPPES registry on August 27, 2024. The provider is doing business as Main Street Dental.

Where is Dental Professionals Of Mississippi, P.C. located?

Dental Professionals Of Mississippi, P.C. is located at 8747 Northwest Dr, Southaven, MS 38671. The listed phone number is (662) 393-0781.

What is Dental Professionals Of Mississippi, P.C.'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 Dental Professionals Of Mississippi, P.C. was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.