Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellisville State School Dental

Organization Dentist · NPI 1013085414

Ellisville State School Dental provides Dentist services in Ellisville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1101 Highway 11 S
Ellisville, MS 39437-4443
Phone: (601) 477-9384
Fax: (601) 477-5700
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 09013809 (MS)

Record details

NPI number1013085414
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Suzie Lassiter — Director Of Facility · (601) 477-9384
NPI enumeratedDecember 1, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1101 Highway 11 S, Ellisville, MS 39437-4443

Other providers in Ellisville