Oral & Maxillofacial Surgery Clinic of South Misssissippi, P.A.
NPI 1578596060ActiveOrganization· Dentist, Oral and Maxillofacial Surgery· Hattiesburg, MS
Dentist, Oral and Maxillofacial Surgery in Hattiesburg, Mississippi, registered in NPPES in July 2006. The authorized official on file is Sandra P. Odom, Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1578596060 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 8, 2006 |
| Last updated in NPPES | Jul 22, 2020 |
| Certified by provider | Jul 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Oral and Maxillofacial Surgery Primary | 1223S0112X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
Other oral surgeons in Hattiesburg
- 1053752642
- 1164953188
- 1417045386
- 1801416219
- 1225256126
- 1457577686
- 1528220233
- 1841601556
- 1871607812
- 1073188017
- 1487227492
- 1689762528