Abraham Dental Winona, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ABRAHAM DENTAL WINONA, PLLC

Practice address

412 Tyler Holmes Dr
Winona, MS 38967-1522

Phone

(662) 283-4722

NPI assigned

Mar 2, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Robert Michael Abraham Jr., DDS

Title

Owner

Phone

(601) 720-8194

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Harrison Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Louie V Harrison III, DMD

  • General Practice Dentistry
  • Winona, MS
  • NPI 1376712364
  NPD (past)

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1194424747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 676",
            "city": "CALHOUN CITY",
            "state": "MS",
            "postal_code": "389160676",
            "telephone_number": "601-720-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 TYLER HOLMES DR",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389671522",
            "telephone_number": "662-283-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRAHAM DENTAL WINONA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-720-8194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "2987-97",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harrison Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 20-20 Eyecare of Winona LLC
• 627 Middleton Road Opco LLC
• Brooke Lynn Anderson, RBT
• Roger Beardain, RPH
• Patty Beck
• Rebecca Smart Bennett, LPC
• Leslie Leigh Black

• All providers in Winona, MS
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.