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

Vicksburg Orthodontics LLC

Organization Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1619370012

Vicksburg Orthodontics LLC is an Orthodontics and Dentofacial Orthopedics Dentistry in Vicksburg, Mississippi. Licensed in Mississippi. Registered with an NPI since 2014.

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

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Practice location Address checks out

1909A Mission 66
Vicksburg, MS 39180-3711
Phone: (601) 271-8710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence 2940-96 (MS)

Record details

NPI number1619370012
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lake Garner — Owner · (601) 271-8710
NPI enumeratedSeptember 30, 2014
Last updated in NPPESSeptember 30, 2014
Mailing address25 Shears Rd, Hattiesburg, MS 39402-8849

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