Wayne Travis Adkison, DMD
Individual provider Active NPI Dentist · Moss Point, MS
NPI 1255433462 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255433462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 195882 (MS)
- Practice address
- 4400 McInnis Ave
Moss Point, MS 39563-2814 - Phone
- (228) 475-0005
- Fax
- (228) 475-0057
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 195882 | MS | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Dental Care PLLC | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 195882 | MS | Yes |
Addresses
Primary practice location
4400 McInnis Ave
Moss Point, MS 39563-2814
Mailing address
4400 McInnis Ave
Moss Point, MS 39563-2814
Phone (228) 475-0005
Other providers in Moss Point, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.