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Shields Orofacial Pain & Dental Sleep, LLC.

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Company Details

Name: Shields Orofacial Pain & Dental Sleep, LLC.
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 03 May 2023 (2 years ago)
Business ID: 1391349
ZIP code: 39110
County: Madison
State of Incorporation: MISSISSIPPI
Principal Office Address: 504 Keywood Circle, Suite AFlowood, MS 39110
Fictitious names: Mississippi Center for Orofacial Pain and Dental Sleep Medicine
MS Pain and Sleep
MS Pain and Dental Sleep

Agent

Name Role Address
Wesley Glen Shields Agent 102 Cambridge Court, Madison, MS 39110

Manager

Name Role Address
Wesley Glen Shields Manager 102 Cambridge Court, Madison, MS 39110

National Provider Identifier

NPI Number:
1972317626
Certification Date:
2025-02-04

Authorized Person:

Name:
DR. WESLEY SHIELDS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
332BC3200X - Customized Equipment (DME)
Is Primary:
No
Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6013519871

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-06-27 Annual Report For Shields Orofacial Pain & Dental Sleep, LLC.
Fictitious Name Registration Filed 2023-09-06 Fictitious Name Registration For Shields Orofacial Pain & Dental Sleep, LLC.
Formation Form Filed 2023-05-02 Formation For Shields Orofacial Pain & Dental Sleep, LLC.

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Date of last update: 20 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website