Wren Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

PEDO-402-07 Issued in MS

Legal business name

WREN PEDIATRIC DENTISTRY, PLLC

Practice address

1390 W Government St
Suite B
Brandon, MS 39042-3272

Phone

(601) 824-0093

Fax

(601) 825-0240

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Josh Wren, DMD

Title

Owner

Phone

(601) 824-0093

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Joshua Wren, D.M.D

  • Pediatric Dentistry
  • Brandon, MS
  • NPI 1740308733
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1235339284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 W GOVERNMENT ST",
            "address_2": "SUITE B",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423272",
            "telephone_number": "601-824-0093",
            "fax_number": "601-825-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 W GOVERNMENT ST",
            "address_2": "SUITE B",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390423272",
            "telephone_number": "601-824-0093",
            "fax_number": "601-825-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WREN PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "WREN",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-824-0093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "PEDO-402-07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07707591",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Boone Wofford, DPT
• Bobby Joe Wolfe Jr.
• Kimberly Denise Woodhouse
• Matthew Woodruff
• Cheryl Lynn Dowell Worrell, M.S.
• Joshua Wren, D.M.D
• Fredriquia Wright
• Sylver Yarn, MSW, CMHT
• Zandriah D Young-Ragsdale
• John Russell Young, PT

• Pediatric Dentistry in Brandon, MS
• Providers in Brandon, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.