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MY VICKSBURG DENTIST
NPI 1962831719
Dentist - General Practice in Vicksburg, MS

Active since November 02, 2013
1805 MISSION 66, VICKSBURG, MS 39180(601) 638-2361(601) 634-0864 Get Directions Write a Review

NPPES record last updated: November 2, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About My Vicksburg Dentist NPPES

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

MY VICKSBURG DENTIST (NPI 1962831719) is a healthcare organization registered as a general practice in Vicksburg, Mississippi and active in the NPI registry since November 2013. The organization lists Kim Wilson, Cred. Supervisor, as its authorized official.

NPPES Registry Identity

NPI1962831719
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Location Address1805 MISSION 66Vicksburg, MS 39180-3709
Mailing Address1805 Mission 66Vicksburg, MS 39180-3709 · (601) 638-2361 · Fax (601) 634-0864
Phone(601) 638-2361
Fax(601) 634-0864
Organization SubpartYes
Authorized OfficialKim WilsonCred. Supervisor · (217) 540-5170
Enumeration DateNovember 2, 2013
✔ NPI 1962831719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.

1805 MISSION 66, Vicksburg, MS 39180
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Other Names 1

Doing Business AsMy Vicksburg Dentist

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

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 3

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

DR. CHARLES BRENT THOMAS DMD
Dentist (General Practice)
1805 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 638-2361
BRENT THOMAS DMD PA
Dentist (General Practice)
1805 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 638-2361
DELTA KATHERINE STOUT DMD
Dentist
1805 MISSION 66
VICKSBURG, MS 39180
Warren County (601) 638-2361

Frequently Asked Questions

What is DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.'s NPI number?

The NPI number assigned to this healthcare provider is 1962831719, enumerated as an "organization" on November 02, 2013.

Where is the provider located?

The provider is located at 1805 MISSION 66 VICKSBURG, MS 39180 and the phone number is (601) 638-2361.

What is the provider's specialty?

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

What insurance does DENTAL PROFESSIONALS OF MISSISSIPPI, P.C. accept?

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.