RESERVOIR SMILES DENTISTRY, PLLC


Address: 1149 Old Fannin Rd Ste 26, Brandon, MS 39047-9244
Phone: 6019927972

RESERVOIR SMILES DENTISTRY, PLLC (NPI# 1316458136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316458136
Entity Type Organization
Organization Name RESERVOIR SMILES DENTISTRY, PLLC
Practice Address 1149 Old Fannin Rd Ste 26
Brandon
MS 39047-9244
Practice Telephone 6019927972
Practice Fax Number 6019927975
Mailing Telephone 6019927972
Mailing Fax Number 6019927975
Enumeration Date 2017-10-19
Last Update Date 2017-10-19
Authorized Official Name DR. AMYE LEE SHAMBURGER (OWNER)
Authorized Official Telephone 7697983909
Authorized Official Credential DMD
Is Organization Subpart Y
Parent Organization Name HALL FAMILY DENTISTRY

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
3421 MS Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MS DR. AMYE L SHAMBURGER 1376725754 01

Office Location

Street Address 1149 OLD FANNIN RD STE 26
City BRANDON
State MS
Zip Code 39047-9244

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396368783 Siyuan Chen Kennedy Counselor 108 Sandstone Drive, Brandon, MS 39047 2020-05-20
1568019784 Juarez Brown Emerson Registered Nurse 426 Pinebrook Circle, Brandon, MS 39047 2019-08-22
1649764127 Specialty Diagnostics LLC Family Medicine 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 2018-06-19
1528423035 Kathlene Strangeman Social Worker 111 Lakeshore Dr Apt G403, Brandon, MS 39047 2015-12-28
1174935076 Anthony Davis Counselor 198 Bellegrove Cir, Brandon, MS 39047 2014-05-27
1144659178 Medical Foundation of Central Ms, Inc Family Medicine 1887 Spillway Rd., Brandon, MS 39047 2013-11-12
1437429941 Picton Timothy Evans Pharmacist 150 B Cumberland Ed, Brandon, MS 39047 2012-01-01
1275828030 Kathryn Audell Piburn Nurse Practitioner 1887 Spillway Rd Ste 140, Brandon, MS 39047 2011-06-09
1801930532 Susanne Reynolds Moore Dentist 1149 Old Fannin Rd, Suite 26, Brandon, MS 39047 2007-02-16
1194898429 Brookshire Grocery Company Durable Medical Equipment & Medical Supplies 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 2006-11-16
Find all providers in zip 39047

Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982242111 Lumina Dentalof Brandon, Pa Clinic/Center 225 Brandon Town Center Dr, Brandon, FL 33511-4728 2019-12-18
1083099600 Skylight Dental Care Pllc Clinic/Center 117 N. Oakwood Avenue, Brandon, FL 33510 2015-07-24
1841617305 Mobile Health Solutions Inc Clinic/Center 1700 W Government St Ste 203, Brandon, MS 39042-2423 2014-03-23
1578122172 Vladimir A. Avril, Pllc Clinic/Center 3413 S Kings Ave Ste 200, Brandon, FL 33511-7780 2019-06-07
1770064388 Brandon Family Dentistry Clinic/Center 5 Carver St, Brandon, VT 05733-1103 2018-08-22
1073057964 Suncoast Community Health Centers, Inc Clinic/Center 313 S Lakewood Dr, Brandon, FL 33511-2815 2016-12-12
1013325265 Bruce D. Waterman, Dmd,pa Clinic/Center 127 Kingsway Rd, Brandon, FL 33510-4601 2014-07-31
1902220320 Bruce Waterman Dmd, Sleep Ez,pl Clinic/Center 127 Kingsway Rd, Brandon, FL 33510-4601 2014-02-05
1265779052 Grants Ferry Family Dentistry Clinic/Center 1075 Lake Village Cir, Brandon, MS 39047-6743 2013-01-14
1164607552 Family Health Care Clinic, Inc. Clinic/Center 1551 W Government St, Brandon, MS 39042 2008-01-03
Find all providers in BRANDON

Competitor

Search similar providers

City BRANDON
Zip Code 39047

Improve Information

Please comment or provide details below to improve the information on RESERVOIR SMILES DENTISTRY, PLLC.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches