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Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Lifetime Dental LLC

Dentist in Greenwood, MS · enumerated 2016 · authorized official Daryl Johnson, Sole Proprietor.

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

National Provider Identifier

1679024442

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Registry record

Entity type Organization (Type 2)
Legal business name Lifetime Dental LLC
Parent organization Johnson Dental Clinic Inc
Practice address 910 Medallion Dr, Greenwood, MS, 38930
Phone (662) 843-8353
Fax (662) 843-8363
Enumeration date Oct 17, 2016
Last updated in NPPES Oct 17, 2016

Taxonomy & classification

122300000X Dentist Dental Providers · License 2826-94 (MS) Primary

Authorized official

Name Daryl Johnson
Title Sole Proprietor
Phone (662) 843-8353

Other identifiers

Identifier Type State Issuer
09015931 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.

Read the full guide → Validate an NPI →

Frequently asked questions

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.
What type of organization is Lifetime Dental LLC?
Lifetime Dental LLC is registered in NPPES as a Dentist (its primary provider taxonomy).

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2016-10-17.