Provider Demographics
NPI:1326763558
Name:ANNA JENNINGS NIX, DMD, PLLC
Entity Type:Organization
Organization Name:ANNA JENNINGS NIX, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:JENNINGS
Authorized Official - Last Name:NIX
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-924-4900
Mailing Address - Street 1:315 PENROSE PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-1200
Mailing Address - Country:US
Mailing Address - Phone:662-299-5530
Mailing Address - Fax:
Practice Address - Street 1:539 HIGHWAY 80 W STE A
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4156
Practice Address - Country:US
Practice Address - Phone:601-924-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty