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LEAF RIVER DENTAL, PLLC
NPI 1750906707
Clinic/Center - Dental in Petal, MS

Active since June 15, 2020
1115 EVELYN GANDY PARKWAY, PETAL, MS 39465(601) 271-8710 Get Directions Write a Review

NPPES record last updated: June 15, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Leaf River Dental, Pllc NPPES

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

LEAF RIVER DENTAL, PLLC (NPI 1750906707) is a healthcare organization registered as a dental in Petal, Mississippi and active in the NPI registry since June 2020. The organization lists Lanthea Mangum, Coo, as its authorized official.

NPPES Registry Identity

NPI1750906707
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameLEAF RIVER DENTAL, PLLC
Location Address1115 EVELYN GANDY PARKWAYPetal, MS 39465
Mailing Address4358 Lincoln Road Ext Ste 20Hattiesburg, MS 39402-3275 · (601) 271-8710
Phone(601) 271-8710
Organization SubpartNo
Authorized OfficialLanthea MangumCoo · (601) 271-8710
Enumeration DateJune 15, 2020
NPPES CertifiedJune 15, 2020
✔ NPI 1750906707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1115 EVELYN GANDY PARKWAY, Petal, MS 39465
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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. CHANDLER MCCARLEY HAWKINS DMD
Dentist (General Practice)
1115 EVELYN GANDY PARKWAY
PETAL, MS 39465
Forrest County (014) 755-6006
DR. HUNTER HAWKINS DMD
Dentist (General Practice)
1115 EVELYN GANDY PARKWAY
PETAL, MS 39465
Forrest County (601) 475-5600

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 Leaf River Dental, PLLC's NPI number?

The NPI number for Leaf River Dental, PLLC is 1750906707. It was assigned to this organization in the NPPES registry on June 15, 2020.

Where is Leaf River Dental, PLLC located?

Leaf River Dental, PLLC is located at 1115 Evelyn Gandy Parkway, Petal, MS 39465. The listed phone number is (601) 271-8710.

What is Leaf River Dental, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Leaf River Dental, PLLC was last updated on June 15, 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.