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 is a Dentist in Ellisville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
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Practice location Address checks out

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