Doctor profile · Federal record
Dr. Heatherly Grissom, D.M.D.
General Practice Dentistry · Madison, MS
- NPI 1699921965
- 18 yrs on file
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
1896 Main St, Suite B
Madison, MS 391107676
(601) 898-9390
fax (601) 898-9395
Credentials & registration
- NPI registered
- August 2008 — 18 yrs on file
- Specialty taxonomy
- 1223G0001X — NUCC code
- State license (1)
- Mississippi #3228-02
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1699921965. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$81
Transactions
2
Manufacturers
2
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Zimvie INC. | 1 | $64.82 | |
| Dentsply Sirona INC | 1 | $15.92 |
By nature of payment
Frequently asked questions
What is Dr. Heatherly Grissom's medical specialty?
Dr. Heatherly Grissom practices General Practice Dentistry in Madison, MS.
Where does Dr. Heatherly Grissom practice?
Dr. Heatherly Grissom practices at 1896 Main St, Madison, MS 391107676. Office phone: 6018989390.
What is Dr. Heatherly Grissom's NPI?
Dr. Heatherly Grissom's National Provider Identifier (NPI) is 1699921965, issued by NPPES.