DR. FREDDIE EARL WILKES D.D.S. NPI 1972859627

NPI Information

NPI: 1972859627
Provider Name: DR. FREDDIE EARL WILKES, D.D.S.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

PECOS Registration: Yes

Address:
2154 GOODMAN RD W # 1
HORN LAKE, MS
ZIP 38637
Phone: (662) 392-9200
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DR. Freddie Earl Wilkes, D.D.S. is a pediatric dentistry dentist in Horn Lake, MS. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Freddie Earl Wilkes, D.D.S. NPI is 1972859627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2154 GOODMAN RD W # 1
HORN LAKE, MS
ZIP 38637-303
Phone: (662) 392-9200

The NPI 1972859627 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/31/2012 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		RES.3249	OHIO	No
2	1223P0221X	Dentist	Pediatric Dentistry	4346-22	MISSISSIPPI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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