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
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2154 GOODMAN RD W # 1
    HORN LAKE, MS
    ZIP 38637
  • Phone: (662) 392-9200

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NPI Details

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
1122300000XDentistRES.3249OHIONo
21223P0221XDentistPediatric Dentistry4346-22MISSISSIPPIYes

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: 11/21/2025

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