Ellisville State School Dental is a Dental Clinic in Ellisville, Mississippi. It is located at 1101 Highway 11 S, Ellisville, MS and its contact number is 601-477-9384. The authorized person for Ellisville State School Dental is Suzie Lassiter
who is Director Of Facility of the clinic and their contact number is 601-477-9384. The primary license number for Ellisville State School Dental is 09013809 (Dentist) in Mississippi.
Ellisville State School Dental Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Ellisville State School Dental Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Ellisville State School Dental |
| Specialization: | Dentistry |
| Clinic Address: | 1101 Highway 11 S, Ellisville,
Mississippi, 39437-4443 |
| Phone: | 601-477-9384 |
| Fax: | 601-477-5700 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Suzie Lassiter |
| Position: | Director Of Facility |
| Contact Number: | 601-477-9384 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Ellisville State School Dental clinic are as mentioned below.
| NPI Number: | 1013085414 |
| NPI Enumeration Date: | 01 Dec, 2006 |
| NPI Last Update On: | 22 Aug, 2020 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Ellisville State School Dental are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | 09013809 | Mississippi | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 09013809 | Medicaid | Mississippi | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Ellisville State School Dental
1101 Highway 11 S,
Ellisville, Mississippi |
| Zip: | 39437-4443 |
| Phone Number: | 601-477-9384 |
| Fax Number: | 601-477-5700 |
Patients can reach Ellisville State School Dental at
1101 Highway 11 S, Ellisville, Mississippi or can
call to book an appointment on 601-477-9384.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.