Healthcare Provider Details

I. General information

NPI: 1255269858
Provider Name (Legal Business Name): DARREN LEE EMERSON PAAP II DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 HOSPITAL DR
COLUMBUS MS
39705-1920
US

IV. Provider business mailing address

115 WINDOVER LN
STARKVILLE MS
39759-4154
US

V. Phone/Fax

Practice location:
  • Phone: 662-328-1825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112715
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: