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AUDREY LEE FORTIN DMD
NPI 1922688001
Dentist - General Practice in Jackson, MS

Active since April 12, 2021
989 ELLIS AVE, JACKSON, MS 39209(769) 235-3919 Get Directions Write a Review

NPPES record last updated: July 7, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 7, 2022, Apr 12, 2021 (2 updates tracked since 2021).

About Audrey Lee Fortin Dmd NPPES

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

AUDREY LEE FORTIN DMD (NPI 1922688001) is an individual general practice provider in Jackson, Mississippi, licensed in Mississippi (4289-22) and active in the NPI registry since April 2021. She maintains a secondary practice location in Ridgeland.

NPPES Registry Identity

NPI1922688001
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameAUDREY LEE FORTINCredential: DMD
Location Address989 ELLIS AVEJackson, MS 39209-6256
Mailing Address649 Muirwood CirRidgeland, MS 39157-3623 · (662) 560-7211
Phone(769) 235-3919
Sole ProprietorYes
Enumeration DateApril 12, 2021
Last NPPES UpdateJuly 7, 20222 updates tracked since enumeration
NPPES CertifiedJuly 7, 2022
✔ NPI 1922688001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MS · 4289-22
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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
989 ELLIS AVE, Jackson, MS 39209
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Secondary Practice Location 1

Location 1649 Muirwood CirRidgeland, MS 39157-3623 · Phone (662) 560-7211

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Other Providers at the Same Location NPPES 4

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

DR. RICHARD NELSON SMITH DMD
Dentist (General Practice)
989 ELLIS AVE
JACKSON, MS 39209
Hinds County (601) 354-3557
DR. DIVIJA TAKKALAPELLY
Dentist (Orthodontics and Dentofacial Orthopedics)
989 ELLIS AVE
JACKSON, MS 39209
Hinds County (769) 235-3019
MELANIE PAIGE-BROWN
Dentist (General Practice)
989 ELLIS AVE
JACKSON, MS 39209
Hinds County (601) 354-3557
HATTIESBURG ROAD DENTAL, P.C.
Dentist (General Practice)
989 ELLIS AVE
JACKSON, MS 39209
Hinds County (678) 904-5665

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 Audrey Fortin's NPI number?

The NPI number for Audrey Fortin is 1922688001. It was assigned to this individual provider in the NPPES registry on April 12, 2021.

Where is Audrey Fortin located?

Audrey Fortin practices at 989 Ellis Ave, Jackson, MS 39209. The listed phone number is (769) 235-3919.

What is Audrey Fortin's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Audrey Fortin accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 12 other insurers list Audrey Fortin 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 Audrey Fortin was last updated on July 7, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.