Provider Demographics
NPI:1659464741
Name:SINGLETARY, ALBERT JESSE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:JESSE
Last Name:SINGLETARY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 WEST GEORGETOWN ST.
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39059
Mailing Address - Country:US
Mailing Address - Phone:601-892-3444
Mailing Address - Fax:601-892-4778
Practice Address - Street 1:707 WEST GEORGETOWN ST.
Practice Address - Street 2:
Practice Address - City:CRYSTAL SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39059
Practice Address - Country:US
Practice Address - Phone:601-892-3444
Practice Address - Fax:601-892-4778
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2035 831223G0001X
MS2035-831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00660412Medicaid
MS00660412Medicaid