Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Periodontal Associates of Jackson, PA

Organization Periodontics · NPI 1790069854

Periodontal Associates of Jackson, PA provides Periodontics in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2011.

Licensed in
MS
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

406 Briarwood Dr Ste 101
Jackson, MS 39206 Not confirmed with CMS for 15 years — call before visiting
Phone: (601) 956-1230
Fax: (601) 956-0201
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 1845-79 (MS)
Periodontics Taxonomy 1223P0300X · Licence 2364-87 (MS)

Record details

NPI number1790069854
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Parkes — Owner/Dentist · (601) 956-1230
NPI enumeratedOctober 6, 2011
Last updated in NPPESOctober 6, 2011
Mailing address406 Briarwood Dr., Ste. 101, Jackson, MS 39206

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