DENTAL GROUP OF MAGEE PLLC — NPI 1053707083 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in MAGEE, MS)

CMS-1500 Box 24J / 33a • NPI

1053707083

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

122300000X (CMS C5)

Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)

Box 32 Service Location & ZIP+4

1667 HIGHWAY 49S STE 6, MAGEE, MS, 39111

Official NPPES Practice Location

Practice Phone & Referral Fax

(601) 271-8710

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1053707083 (DENTAL GROUP OF MAGEE PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1053707083` (NPI-2 Organization / Facility)
Provider / Legal Name	DENTAL GROUP OF MAGEE PLLC
Plain-English Specialty	Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: `122300000X` (Dentist)
Certifying / Licensing Body	American Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address	1667 HIGHWAY 49S STE 6, MAGEE, MS, 39111
Practice Telephone / Fax	Tel: (601) 271-8710
Administrative Mailing Address	4358 LINCOLN ROAD EXT STE 10, HATTIESBURG, MS, 39402-3275
Enumeration & Last Sync	Enumerated: 2015-04-07 \| CMS Record Updated: 2015-04-07
Authorized Official	TERRY GARNER (Member)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1667 HIGHWAY 49S STE 6, MAGEE, MS, 39111

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Plain-English Taxonomy & CMS Crosswalk (122300000X)

What Does Taxonomy Code 122300000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 122300000X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code C5 (Dentist)
Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
Clinical Scope: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DENTAL GROUP OF MAGEE PLLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions

Common Therapeutic Classes:

Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`122300000X` — Dentist Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: MS \| License: `294096` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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DENTAL GROUP OF MAGEE PLLC (NPI #1053707083)