KELLUM DENTAL CLINIC
NPI 1528280880
Clinic/Center - Dental in Tupelo, MS
Active since May 03, 2007
About Kellum Dental Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLUM DENTAL CLINIC (NPI 1528280880) is a healthcare organization registered as a dental in Tupelo, Mississippi and active in the NPI registry since May 2007. The organization lists Shaundi B. Little, Office Manager, as its authorized official.
NPPES Registry Identity
NPI1528280880
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameKELLUM DENTAL CLINIC
Location Address505 ROBINS STTupelo, MS 38804-3715
Mailing AddressPo Box 1486Tupelo, MS 38802-1486 · (662) 842-5080 · Fax (662) 842-5896
Phone(662) 842-5080
Fax(662) 842-5896
Organization SubpartNo
Authorized OfficialShaundi B. LittleOffice Manager · (662) 842-5080
Enumeration DateMay 3, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1528280880 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
Licenses✔ Licensed in MS · 1782-77✔ Licensed in MS · 2554-90
505 ROBINS ST, Tupelo, MS 38804
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.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1528280880, enumerated as an "organization" on May 03, 2007.
The provider is located at 505 ROBINS ST TUPELO, MS 38804 and the phone number is (662) 842-5080.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
