1. Home
  2. Directory
  3. Mississippi
  4. Jackson
  5. Public Health Or Welfare
  6. NPI Profile
  7. NPI Record 1457520173

CHOICES FOR DENTAL MOBILE UNIT
Complete NPI Record 1457520173
Public Health or Welfare in Jackson, MS

NPI Status: Active since February 27, 2008

Contact Information

2941 TERRY RD STE 22
JACKSON, MS
ZIP 39212
Phone: (601) 373-0566

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Title or Position
  24. Authorized Official Telephone Number
  25. Healthcare Provider Taxonomy Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Is Organization Subpart
  28. Parent Organization LBN
  29. Parent Organization TIN
  30. Authorized Official Name Prefix Text

Complete NPI Dataset

This page represents the complete record for NPI 1457520173. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1457520173
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The last name of the provider. If the provider is an individual, this is the legal name.
The first name of the provider, if the provider is an individual.
Provider Other Organization Name: CHOICES FOR DENTAL MOBILE UNIT
The middle name of the provider, if the provider is an individual.
Provider Other Organization Name Type Code: 5
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 2941 TERRY RD STE 22
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: JACKSON
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address State Name: MS
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 392123072
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 6013730566
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 2941 TERRY RD STE 22
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: JACKSON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MS
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 392123072
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6013730566
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 2/27/2008
The telephone number associated with the location address of the provider being identified.
Last Update Date: 4/1/2010
The date that a record was last updated or changed.
Authorized Official Last Name: AUSTIN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: ANNETTE
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Authorized Official Title or Position: CEO
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Authorized Official Telephone Number: 2252616314
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 251K00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Parent Organization LBN: CHOICES FOR DENTAL
Parent Organization TIN: UNAVAIL
Authorized Official Name Prefix Text: MRS.