HATTIESBURG ORAL SURGERY
NPI 1578596060
Dentist - Oral and Maxillofacial Surgery in Hattiesburg, MS
About Hattiesburg Oral Surgery NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HATTIESBURG ORAL SURGERY (NPI 1578596060) is a healthcare organization registered as an oral and maxillofacial surgery in Hattiesburg, Mississippi and active in the NPI registry since July 2006. The organization lists Sandra P Odom, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 3
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Hattiesburg Oral Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Hattiesburg Oral Surgery, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A.'s NPI number?
The NPI number for Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. is 1578596060. It was assigned to this organization in the NPPES registry on July 8, 2006. The provider is doing business as Hattiesburg Oral Surgery. The provider is also known as Drs. York, Bishop & West and Drs. York, Cockerham & Hughes.
Where is Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. located?
Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. is located at 1421 S 28th Ave, Hattiesburg, MS 39402. The listed phone number is (601) 264-7611.
What is Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A.'s specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. enrolled in Medicare?
Yes. Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. is registered in the Medicare PECOS enrollment system.
When is Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Oral Surgery, reassign their Medicare billing to Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.A. was last updated on July 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Hattiesburg Oral Surgery · NPI 1578596060
Oral and Maxillofacial Surgery organization in Hattiesburg, Mississippi. Organization record, active in the CMS NPPES registry since July 8, 2006.
## Identity
- **NPI:** 1578596060 (Entity type: Organization)
- **Enumerated:** July 8, 2006
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **Legal business name:** Oral & Maxillofacial Surgery Clinic Of South Misssissippi, P.a.
- **Also known as:** Drs. York, Bishop & West (Other Name); Drs. York, Cockerham & Hughes (Other Name)
- **Organization subpart:** No
- **Authorized official:** Sandra Odom, ADMINISTRATOR
## Practice location
- **Address:** 1421 S 28TH AVE, Hattiesburg, MS 39402-3108
- **Phone:** (601) 264-7611 · **Fax:** (601) 268-0693
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians (Oral Surgery) reassign Medicare billing to this organization (form CMS-855R); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 22, 2020
- **Other identifiers:** Medicaid 06271376 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1578596060) · Data from the CMS NPPES public registry.