OrganizationActive
South Main Dental Clinic, LLC
NPI 1043756687 · General Practice Dentistry · Pontotoc, MS
South Main Dental Clinic, LLC is a General Practice Dentistry organization in Pontotoc, MS (NPI 1043756687).
Provider details
- NPI number
- 1043756687
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- John Black, Manager(662) 489-7768
- License
- 2066-84 (MS)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
209 S Main St
Pontotoc, MS 38863-3319
Phone: (662) 489-7768
Fax: (662) 489-8256
Street-level locationGet directions
Mailing address
209 S Main St
Pontotoc, MS 38863-3319
Other names (DBA / former)
- Doing business as
- South Main Dental
Registry dates
- Enumerated
- 2017-01-06
- Last updated
- 2017-01-06
Frequently asked questions
- What is South Main Dental Clinic, LLC's NPI number?
- South Main Dental Clinic, LLC's National Provider Identifier (NPI) is 1043756687, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Main Dental Clinic, LLC?
- South Main Dental Clinic, LLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is South Main Dental Clinic, LLC located?
- South Main Dental Clinic, LLC's practice location on file with NPPES is 209 S Main St, Pontotoc, MS 38863-3319.
- What is South Main Dental Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for South Main Dental Clinic, LLC is (662) 489-7768.
- Who is the authorized official for South Main Dental Clinic, LLC?
- The authorized official listed on South Main Dental Clinic, LLC's NPPES record is John Black, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Main Dental Clinic, LLC's NPI active?
- Yes — South Main Dental Clinic, LLC's NPI (1043756687) is active in the NPPES registry as of the last update on 2017-01-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.