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DENTAL GROUP OF ELLISVILLE, PLLC
NPI 1972851814
Dentist - General Practice in Ellisville, MS

Active since August 27, 2012
97 HAL CROCKER ROAD, ELLISVILLE, MS 39437(601) 477-3779(601) 477-3770 Get Directions Write a Review

NPPES record last updated: March 18, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 18, 2019, Mar 1, 2019 (2 updates tracked since 2019).

About Dental Group Of Ellisville, Pllc NPPES

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

DENTAL GROUP OF ELLISVILLE, PLLC (NPI 1972851814) is a healthcare organization registered as a general practice in Ellisville, Mississippi and active in the NPI registry since August 2012. The organization lists Terry Lake Garner, Owner, as its authorized official.

NPPES Registry Identity

NPI1972851814
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDENTAL GROUP OF ELLISVILLE, PLLC
Location Address97 HAL CROCKER ROADEllisville, MS 39437
Mailing Address97 Hal Crocker RoadEllisville, MS 39437 · (601) 477-3779 · Fax (601) 477-3770
Phone(601) 477-3779
Fax(601) 477-3770
Organization SubpartNo
Authorized OfficialTerry Lake GarnerOwner · (601) 271-8710
Enumeration DateAugust 27, 2012
Last NPPES UpdateMarch 18, 20192 updates tracked since enumeration
✔ NPI 1972851814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MS · 2940-96
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.
97 HAL CROCKER ROAD, Ellisville, MS 39437
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Other Identifiers 1

Medicaid00660377MS

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 MULTIPLE SINGLE SPECIALTY GROUP

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 Dental Group Of Ellisville, PLLC's NPI number?

The NPI number for Dental Group Of Ellisville, PLLC is 1972851814. It was assigned to this organization in the NPPES registry on August 27, 2012.

Where is Dental Group Of Ellisville, PLLC located?

Dental Group Of Ellisville, PLLC is located at 97 Hal Crocker Road, Ellisville, MS 39437. The listed phone number is (601) 477-3779.

What is Dental Group Of Ellisville, PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Dental Group Of Ellisville, PLLC was last updated on March 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.