Doctor profile · Federal record

Dr. Audrey Fortin, DMD

General Practice Dentistry · Student in an Organized Health Care Education/Training Program · Jackson, MS

  • NPI 1922688001
  • 5 yrs on file
  • Female
  • Solo practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
989 Ellis Ave
Jackson, MS 392096256
(769) 235-3919
Additional location
649 Muirwood Cir
Ridgeland, MS 391573623
(662) 560-7211
Mailing address
649 Muirwood Cir
Ridgeland, MS 391573623

Credentials & registration

NPPES · NUCC
NPI registered
April 2021 — 5 yrs on file
Profile last updated
July 7, 2022
Specialty taxonomy
1223G0001X — NUCC code
State license (1)
Mississippi #4289-22

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1922688001. Last verified May 11, 2026.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$115
Transactions
2
Manufacturers
1
Payer (manufacturer) Industry Txns Amount
ZIMVIE INC. 2 $115.22

By nature of payment

Food and Beverage
$115

Frequently asked questions

Auto-generated from federal data
What is Dr. Audrey Fortin's medical specialty?
Dr. Audrey Fortin practices General Practice Dentistry in Jackson, MS.
Where does Dr. Audrey Fortin practice?
Dr. Audrey Fortin practices at 989 Ellis Ave, Jackson, MS 392096256. Office phone: 7692353919.
What is Dr. Audrey Fortin's NPI?
Dr. Audrey Fortin's National Provider Identifier (NPI) is 1922688001, issued by NPPES.