DR. BERNARD FREDERICK PODLIN (NPI# 1730385139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730385139 |
| Entity Type | Individual |
| Full Name | DR. BERNARD FREDERICK PODLIN |
| Credential | DDS MS |
| Practice Address |
400 Pass Road Gulfport MS 39507 |
| Practice Telephone | 2288683616 |
| Practice Fax Number | 2288683616 |
| Mailing Telephone | 2288683616 |
| Mailing Fax Number | 2288683616 |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
PER00577176577 | MS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 64754 | 05 |
| Street Address |
400 PASS ROAD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
| 1538605027 | Andrea Broussard | Personal Emergency Response Attendant | 406 Pass Rd, Gulfport, MS 39507 | 2017-01-09 |
| 1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
| 1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
| 1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
| 1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
| 1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
| 1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
| 1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
| 1619003191 | Arthur Tripp | Chiropractor | 422 Security Square, Dr Arthur Tripp Traditional Chiropractic, Gulfport, MS 39507 | 2007-02-26 |
| Find all providers in zip 39507 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871656686 | Enrique Lacuesta | Dentist | 22-29th Street, Suite A, Gulfport, MS 39507 | 2006-12-19 |
| 1588747737 | Jeffery Y. Taylor | Dentist | 431 Security Sq, Gulfport, MS 39507-1922 | 2006-10-23 |
| 1932282563 | Jeffery Y. Taylor Dmd, Pa | Dentist | 431 Security Sq, Gulfport, MS 39507-1922 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497112825 | Mississippi Periodontics and Implants Pllc | Dentist | 218 West Jackson Street, Ridgeland, MS 39157 | 2016-01-15 |
| 1932531373 | North Mississippi Periodontics & Implant Dentistry Pllc | Dentist | 103 Park Gate Ext, Tupelo, MS 38801-3038 | 2013-08-08 |
| 1851640437 | Ms Periodontic Specialists Group, Pllc | Dentist | 209 Woodline Dr., Flowood, MS 39232 | 2012-08-29 |
| 1790069854 | Periodontal Associates of Jackson, P.a. | Dentist | 406 Briarwood Dr., Ste. 101, Jackson, MS 39206 | 2011-10-06 |
| 1992997159 | Rodney C Richardson | Dentist | 1609 24th Ave, Meridian, MS 39301-3112 | 2007-08-13 |
| 1699966770 | Brenda Lyle Fowler | Dentist | 2408 S Lamar Blvd, Suite 3, Oxford, MS 38655-5345 | 2007-08-05 |
| 1417166703 | R. Clarke Stewart | Dentist | 406 Briarwood Dr Ste 101, Jackson, MS 39206-3059 | 2007-05-22 |
| 1750594412 | James Michael Robertson | Dentist | 103 Parkgate Drive Extended, Tupelo, MS 38801-3038 | 2007-05-08 |
| 1134341407 | Nichols Periodontics LLC | Dentist | 2401 5th Street North, Suite 2, Columbus, MS 39705 | 2007-05-03 |
| 1689719486 | Charles Joseph Caskey | Dentist | 218 West Jackson St., Ridgeland, MS 39157 | 2007-02-20 |
| Find all providers with the same taxonomy | ||||
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| 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.