OrganizationActive
627 Main Tupelo Professional PLLC
NPI 1255045019 · General Practice Dentistry · Tupelo, MS
627 Main Tupelo Professional PLLC is a General Practice Dentistry organization in Tupelo, MS (NPI 1255045019).
Provider details
- NPI number
- 1255045019
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Peter Grumbos, Owner(662) 840-0066
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 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
627 W Main St
Tupelo, MS 38804-3732
Phone: (662) 840-0066
Fax: (662) 840-7966
Street-level locationGet directions
Mailing address
627 W Main St
Tupelo, MS 38804-3732
Other names (DBA / former)
- Doing business as
- Main Street Family Dentistry
Registry dates
- Enumerated
- 2023-01-06
- Last updated
- 2023-01-06
- Certified
- 2023-01-06
Frequently asked questions
- What is 627 Main Tupelo Professional PLLC's NPI number?
- 627 Main Tupelo Professional PLLC's National Provider Identifier (NPI) is 1255045019, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 627 Main Tupelo Professional PLLC?
- 627 Main Tupelo Professional PLLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is 627 Main Tupelo Professional PLLC located?
- 627 Main Tupelo Professional PLLC's practice location on file with NPPES is 627 W Main St, Tupelo, MS 38804-3732.
- What is 627 Main Tupelo Professional PLLC's phone number?
- The practice phone number listed in the NPPES registry for 627 Main Tupelo Professional PLLC is (662) 840-0066.
- Who is the authorized official for 627 Main Tupelo Professional PLLC?
- The authorized official listed on 627 Main Tupelo Professional PLLC's NPPES record is Peter Grumbos, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 627 Main Tupelo Professional PLLC's NPI active?
- Yes — 627 Main Tupelo Professional PLLC's NPI (1255045019) is active in the NPPES registry as of the last update on 2023-01-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.