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Contact Information

AUSTIN FAMILY DENTISTRY
3040 INDIANA AVE
VICKSBURG, MS39180
 Phone: 601-634-6277
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for AUSTIN FAMILY DENTISTRY

NPI Number 1922217314
LBN Legal business name AUSTIN FAMILY DENTISTRY
Authorized official MISTY AUSTIN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/22/2007
Last updated 10/01/2013 - About 13 years ago
Identifiers
MS License # 2063-84
MS Medicaid 09014287
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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