Lloyd B. Wolfe, Jr., D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

210884 Issued in MS

Legal business name

LLOYD B. WOLFE, JR., D.M.D.

Practice address

92 Hal Crocker Rd
Ellisville, MS 39437-2089

Phone

(601) 261-0105

Fax

(601) 800-8064

NPI assigned

May 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lloyd B Wolfe Jr., D.M.D.

Title

Orthodontist

Phone

(601) 261-0105

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Lloyd B Wolfe Jr DMD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lloyd B. Wolfe, Jr., D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jackson, MS
  • NPI 1023239068
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1154533834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 HAL CROCKER RD",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394372089",
            "telephone_number": "601-261-0105",
            "fax_number": "601-800-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 HAL CROCKER RD",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394372089",
            "telephone_number": "601-261-0105",
            "fax_number": "601-800-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LLOYD B. WOLFE, JR., D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "601-261-0105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MS",
            "license": "210884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05875831",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Ellisville, MS
• Providers in Ellisville, MS by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.