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

South Jackson Family Dental, PLLC

Organization General Practice Dentistry · NPI 1821406570

South Jackson Family Dental, PLLC provides General Practice Dentistry in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2014.

Licensed in
MS
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5643 Highway 18 W Ste G
Jackson, MS 39209-9529 Not confirmed with CMS for 12 years — call before visiting
Phone: (601) 922-0056
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 2940-96MS (MS)

Record details

NPI number1821406570
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lake Garner — Owner · (601) 271-8710
NPI enumeratedJuly 25, 2014
Last updated in NPPESJuly 25, 2014
Mailing addressPo Box 18560, Hattiesburg, MS 39404-8560

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