COLLINSVILLE FAMILY DENTAL (NPI# 1770883688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770883688 |
| Entity Type | Organization |
| Organization Name | COLLINSVILLE FAMILY DENTAL |
| Practice Address |
9171 A Old Hwy 19n Collinsville MS 39325 |
| Mailing Address |
Po Box 459 Collinsville MS 39325-0459 |
| Practice Telephone | 6016267555 |
| Mailing Telephone | 6016267555 |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-10-26 |
| Authorized Official Name | DR. BROCK MARTIN (DENTIST/OWNER) |
| Authorized Official Telephone | 6014825701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 3396-06 | MS | Dental Providers |
| Street Address |
9171 A OLD HWY 19N |
| City | COLLINSVILLE |
| State | MS |
| Zip Code | 39325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033609409 | Anna Victoria Stewart | Speech-Language Pathologist | 11790 Pine Grove Rd, Collinsville, MS 39325 | 2018-05-11 |
| 1083160782 | Chandra Sumlin-brown Dba Sumlin Behavioral Services | Psychiatric Hospital | 8237b Okatibbee Dam Road, Collinsville, MS 39325 | 2016-09-01 |
| 1982948980 | Lisa Wiliams | Registered Nurse | 8237 A Okatibbee Dam Rd, Collinsville, MS 39325 | 2012-11-15 |
| 1942550280 | Adam Turbyfill | Pharmacist | 9155 Hwy 19, Collinsville, MS 39325-0175 | 2012-09-13 |
| 1811001878 | Collinsville Drugs Inc | Pharmacy | 9158 Hwy 19, Collinsville, MS 39325-0175 | 2006-08-18 |
| 1184238396 | Veronica Necole Mcfadden | Student in an Organized Health Care Education/Training Program | 8583 Wilsondale Rd, Collinsville, MS 39325-8957 | 2020-09-04 |
| 1659688422 | Oya Weston Hampton | Counselor | 9056b Collinsville Rd, Collinsville, MS 39325-9100 | 2010-09-01 |
| 1801997606 | Tammy N Henderson | General Practice | 9325c Highway 19 N, Collinsville, MS 39325-9219 | 2006-09-26 |
| 1477642791 | Kid's Clinic, Pllc | General Practice | 9325c Highway 19 N, Collinsville, MS 39325-9219 | 2006-10-12 |
| 1053635565 | Heather Stinson | Counselor | 9101 Collinsville Rd, Collinsville, MS 39325-9224 | 2010-03-26 |
| Find all providers in zip 39325 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770013948 | Brandon Prior | Dentist | 1099 Belt Line Rd Ste J-k, Collinsville, IL 62234-4380 | 2017-06-19 |
| 1679925614 | Jaime Woodall | Dentist | 4721 Kings Mountain Rd, Collinsville, VA 24078-1274 | 2016-07-01 |
| 1801932835 | Michael N Schaulat | Dentist | 308 West Clay Street, Collinsville, IL 62234 | 2007-01-29 |
| 1649322561 | Charles Seymour Borden IIi | Dentist | 724 Saint Louis Rd, Collinsville, IL 62234-2032 | 2007-01-18 |
| 1649372327 | Ronald A Zambaldi | Dentist | 3 Collinsport Dr, Collinsville, IL 62234 | 2006-09-02 |
| 1629080866 | Melissa Bowler | Dentist | 1310 W Main St, Collinsville, OK 74021-3012 | 2006-08-13 |
| 1205841939 | Denise J Unterbrink | Dentist | 2200 Daniels Creek Rd, Collinsville, VA 24078 | 2006-07-30 |
| 1912525205 | Jessica Khiet Quach | Dentist | 4940 Kings Mountain Rd, Collinsville, VA 24078-1812 | 2020-07-13 |
| 1477110963 | Spring Dental Collinsville, Pllc | Dentist | 1111 W Main St, Collinsville, OK 74021-3112 | 2019-05-21 |
| 1306401591 | Signature Family Dental | Dentist | 1170 Belt Line Rd, Collinsville, IL 62234-4372 | 2019-05-03 |
| Find all providers in COLLINSVILLE | ||||
| City | COLLINSVILLE |
| Zip Code | 39325 |
Please comment or provide details below to improve the information on COLLINSVILLE FAMILY DENTAL.
| 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.