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LIFETIME DENTAL LLC
NPI 1679024442
Dentist in Greenwood, MS

Active since October 17, 2016
910 MEDALLION DR, GREENWOOD, MS 38930(662) 843-8353(662) 843-8363 Get Directions Write a Review

NPPES record last updated: October 17, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lifetime Dental Llc NPPES

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

LIFETIME DENTAL LLC (NPI 1679024442) is a healthcare organization registered as a dentist in Greenwood, Mississippi and active in the NPI registry since October 2016. The organization lists Daryl Lance Johnson, Sole Proprietor, as its authorized official.

NPPES Registry Identity

NPI1679024442
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameLIFETIME DENTAL LLC
Location Address910 MEDALLION DRGreenwood, MS 38930-2118
Mailing Address1313 W Highway 8Cleveland, MS 38732-2240 · (662) 843-8353 · Fax (662) 843-8363
Phone(662) 843-8353
Fax(662) 843-8363
Organization SubpartYesParent: Johnson Dental Clinic Inc
Authorized OfficialDaryl Lance JohnsonSole Proprietor · (662) 843-8353
Enumeration DateOctober 17, 2016
✔ NPI 1679024442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MS · 2826-94
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
910 MEDALLION DR, Greenwood, MS 38930
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Other Identifiers 1

Medicaid09015931MS

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. JOHN ALBERT SMITH DDS PA
Dentist (General Practice)
910 MEDALLION DR
GREENWOOD, MS 38930
Leflore County (662) 455-9149
DR. ASHLEY M GRECO DMD
Dentist (General Practice)
910 MEDALLION DR
GREENWOOD, MS 38930
Leflore County (662) 455-9149

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 Lifetime Dental LLC's NPI number?

The NPI number for Lifetime Dental LLC is 1679024442. It was assigned to this organization in the NPPES registry on October 17, 2016.

Where is Lifetime Dental LLC located?

Lifetime Dental LLC is located at 910 Medallion Dr, Greenwood, MS 38930. The listed phone number is (662) 843-8353.

What is Lifetime Dental LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Lifetime Dental LLC was last updated on October 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.