WARREN INGE DENTAL CLINIC (NPI# 1932389467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932389467 |
| Entity Type | Organization |
| Organization Name | WARREN INGE DENTAL CLINIC |
| Practice Address |
702 Martin Luther King St Mound Bayou MS 38762-9314 |
| Mailing Address |
702 Martin Luther King Road Mound Bayou MS 38762-0900 |
| Practice Telephone | 6627412151 |
| Practice Fax Number | 6627412700 |
| Mailing Telephone | 6627412151 |
| Mailing Fax Number | 6627412700 |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-13 |
| Authorized Official Name | MICHELLE PORTER (ACCOUNTS RECEIVABLE COORDINATOR) |
| Authorized Official Telephone | 6627412151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09013120 | 05 |
| Street Address |
702 MARTIN LUTHER KING ST |
| City | MOUND BAYOU |
| State | MS |
| Zip Code | 38762-9314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104848787 | Delta Health Center | Clinic/Center | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2006-07-24 |
| 1053921320 | Sarah Shepherd | Counselor | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2020-08-03 |
| 1043841067 | Anthony Louis Oliveri | Physical Medicine & Rehabilitation | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2020-01-29 |
| 1295290872 | Laura Grant | Clinical Exercise Physiologist | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2019-02-07 |
| 1730602806 | Simone Shardae Williams Moore | Pediatrics | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2017-07-20 |
| 1467999318 | Kirsten Westerfield | Dietitian, Registered | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2017-01-30 |
| 1477090728 | Meta H Anderson | Nurse Practitioner | 702 Martin Luther King St, Pob 900, Mound Bayou, MS 38762-9314 | 2017-01-25 |
| 1124474648 | Natural Pain Back Institute, LLC | Chiropractor | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2016-05-13 |
| 1285041038 | Ronsheka A Palmer | Nurse Practitioner | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2014-07-14 |
| 1831523620 | Alyssa Lott Simmons | Nurse Practitioner | 702 Martin Luther King St, Mound Bayou, MS 38762-9314 | 2013-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891137873 | Beverly C Johnson | Hospice Care, Community Based | 116 S Edward Avenue, Mound Bayou, MS 38762 | 2013-07-19 |
| 1629310487 | Community Adult Day Care | Clinic/Center | 114 S Edwards Avenue, Mound Bayou, MS 38762 | 2013-03-20 |
| 1235482233 | Melvern Scott Jr. | Social Worker | 109 Rayner Rd, Mound Bayou, MS 38762 | 2012-10-16 |
| 1063692770 | Allison Hailman Doyle | Family Medicine | 702 Mlk St, Mound Bayou, MS 38762 | 2007-11-09 |
| 1578785820 | Mound Bayou Public Schools | Registered Nurse | 202 Mlk, Mound Bayou, MS 38762 | 2007-05-03 |
| 1700923836 | Delta Health Center | Clinic/Center | 702 Martin Luther King Rd, Mound Bayou, MS 38762 | 2007-01-30 |
| 1649363656 | Ki M Chang | Internal Medicine | 7165 Getwell Road, Bldg F, Southaven, MS 38762 | 2006-10-02 |
| 1689033706 | North Bolivar Consolidated School District | Local Education Agency (LEA) | 201 Green St, Mound Bayou, MS 38762 | 2016-02-17 |
| 1144398710 | Delta Health Center | Clinic/Center | 702 Martin Luther King Road, Mound Bayou, MS 38762 | 2006-12-01 |
| 1255545570 | Delta Health Center, Inc. | Clinic/Center | 702 Martin Luther King Road, Mound Bayou, MS 38762-0900 | 2007-05-09 |
| Find all providers in zip 38762 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144838970 | Superior Smiles, LLC | Clinic/Center | 16690 E Main St, Louisville, MS 39339-2750 | 2020-07-17 |
| 1255991196 | Sky Family Dental, LLC | Clinic/Center | 200 Meadowlane Street, Eupora, MS 39744 | 2019-06-13 |
| 1851886857 | Grenada Dental Clinic Pllc | Clinic/Center | 1800 Hill Dr Ste A, Grenada, MS 38901-5071 | 2018-06-22 |
| 1467940627 | Ld-columbus LLC | Clinic/Center | 611 Leigh Dr, Columbus, MS 39705-3036 | 2018-04-24 |
| 1821592734 | Integrity Dental Clinic, Pllc | Clinic/Center | 201 E Layfair Dr Ste 100, Flowood, MS 39232-7604 | 2018-03-23 |
| 1336647924 | Murphree's Smile Designers | Clinic/Center | 602 Pegram Dr, Tupelo, MS 38801-6322 | 2018-01-29 |
| 1144735481 | Peoples Dental Pa | Clinic/Center | 1016 Louisville St Ste G, Starkville, MS 39759-3953 | 2017-12-08 |
| 1366956419 | Bradley M Stewart Dmd LLC | Clinic/Center | 6855 Crumpler Blvd Ste 100, Olive Branch, MS 38654-1930 | 2017-11-28 |
| 1316458136 | Reservoir Smiles Dentistry, Pllc | Clinic/Center | 1149 Old Fannin Rd Ste 26, Brandon, MS 39047-9244 | 2017-10-19 |
| 1356851752 | Oakdale Family Dentistry | Clinic/Center | 2139 Hwy 471, Flowood, MS 39232 | 2017-10-11 |
| Find all providers with the same taxonomy | ||||
| City | MOUND BAYOU |
| Zip Code | 38762 |
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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.