Elite Practice Management
NPI 1124630462ActiveOrganization· Dentist· Olive Branch, MS
Dentist in Olive Branch, Mississippi, registered in NPPES in August 2020. The authorized official on file is Kimberly Avant, Practice Manager.
Overview
| NPI | 1124630462 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 18, 2020 |
| Last updated in NPPES | Aug 18, 2020 |
| Certified by provider | Aug 18, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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