Southern Oral and Maxillofacial Surgery Center, Inc
NPI 1073784880 · Oral and Maxillofacial Surgery (Dentist) · Vicksburg, MS
Southern Oral and Maxillofacial Surgery Center, Inc is a Oral and Maxillofacial Surgery (Dentist) organization in Vicksburg, MS (NPI 1073784880).
Provider details
- NPI number
- 1073784880
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Kevin Keen, Surgeon/Owner(601) 661-0034
- License
- 2951-96 (MS)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
Mailing address
Registry dates
- Enumerated
- 2008-03-19
- Last updated
- 2008-03-19
Frequently asked questions
- What is Southern Oral and Maxillofacial Surgery Center, Inc's NPI number?
- Southern Oral and Maxillofacial Surgery Center, Inc's National Provider Identifier (NPI) is 1073784880, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Oral and Maxillofacial Surgery Center, Inc?
- Southern Oral and Maxillofacial Surgery Center, Inc is classified in the NPPES registry as Oral and Maxillofacial Surgery (Dentist) (Dental Providers).
- Where is Southern Oral and Maxillofacial Surgery Center, Inc located?
- Southern Oral and Maxillofacial Surgery Center, Inc's practice location on file with NPPES is 1205 Mission Park Dr, Vicksburg, MS 39180-3747.
- What is Southern Oral and Maxillofacial Surgery Center, Inc's phone number?
- The practice phone number listed in the NPPES registry for Southern Oral and Maxillofacial Surgery Center, Inc is (601) 661-0034.
- Who is the authorized official for Southern Oral and Maxillofacial Surgery Center, Inc?
- The authorized official listed on Southern Oral and Maxillofacial Surgery Center, Inc's NPPES record is Kevin Keen, Surgeon/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Oral and Maxillofacial Surgery Center, Inc's NPI active?
- Yes — Southern Oral and Maxillofacial Surgery Center, Inc's NPI (1073784880) is active in the NPPES registry as of the last update on 2008-03-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.