Main Street Dental is a Dental Clinic in Southaven, Mississippi. It is located at 8747 Northwest Dr, Southaven, MS and its contact number is 662-393-0781. The authorized person for Main Street Dental is Jarad Braddy
who is Member of the clinic and their contact number is 662-393-0781. Other organizations associated with this clinic are Main Street Dental, Dental Professionals Of Mississippi, P.c., The primary license number for Main Street Dental is 3341-05 (Dentist) in Mississippi.
Main Street 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:
Main Street Dental Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Main Street Dental |
| Specialization: | Dentistry |
| Clinic Address: | 8747 Northwest Dr, Southaven,
Mississippi, 38671-2409 |
| Phone: | 662-393-0781 |
| Fax: | 662-342-0750 |
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: | Jarad Braddy |
| Position: | Member |
| Contact Number: | 662-393-0781 |
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 Main Street Dental clinic are as mentioned below.
| NPI Number: | 1043557085 |
| NPI Enumeration Date: | 10 Jan, 2013 |
| NPI Last Update On: | 28 Jan, 2016 |
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
| Name | Specialization | NPI Number |
| Main Street Dental | Dentistry | 1043557085 |
| Dental Professionals Of Mississippi, P.c. | General Practice Dentistry | 1518791292 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Main Street Dental are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | 3341-05 | 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 |
| 082288765 | 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: | Main Street Dental
8747 Northwest Dr,
Southaven, Mississippi |
| Zip: | 38671-2409 |
| Phone Number: | 662-393-0781 |
| Fax Number: | 662-342-0750 |
Patients can reach Main Street Dental at
8747 Northwest Dr, Southaven, Mississippi or can
call to book an appointment on 662-393-0781.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.