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Main Street Dental

Dentist in Southaven, MS · enumerated 2013 · authorized official Jarad Braddy, Member.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1043557085

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Registry record

Entity type Organization (Type 2)
Legal business name Main Street Dental
Other name <Unavail>
Practice address 8747 Northwest Dr, Southaven, MS, 38671
Phone (662) 393-0781
Fax (662) 342-0750
Enumeration date Jan 10, 2013
Last updated in NPPES Jan 28, 2016

Taxonomy & classification

122300000X Dentist Dental Providers · License 3341-05 (MS) Primary

Authorized official

Name Jarad Braddy
Title Member
Phone (662) 393-0781

Other identifiers

Identifier Type State Issuer
082288765 Medicaid MS -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Main Street Dental?
Main Street Dental is registered in NPPES as a Dentist (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2016-01-28.