Dixon J Wise, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

10449 Issued in MS

Practice address

117 S 11TH Ave
Laurel, MS 39440-4312

Phone

(601) 425-3033

Fax

(601) 422-0431

NPI assigned

Nov 8, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Health Center, Inc

  • Clinic/Center
  • Laurel, MS
  • NPI 1760488357

  MS

  Medicare reassignment NPD
• Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ellisville, MS
  • NPI 1083255087
  NPD
• Family Health Center, Inc

  • Specialist
  • Taylorsville, MS
  • NPI 1154502979
  NPD

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1265719959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4361",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394414361",
            "telephone_number": "601-425-3033",
            "fax_number": "601-422-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 11TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404312",
            "telephone_number": "601-425-3033",
            "fax_number": "601-422-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "DIXON",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "10449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Williams
• Niquia L Williams, LPN
• Nathan A Williamson, MD
• Erica Windham, FNP
• James Keith Winstead Jr., D.O.
• Tyesha Wolverton
• Charles Steven Wood Jr., NP-C
• Raquel Wood
• Milton Lavell Woodall, FNP-C
• Sarah M Wooten, NP

• All providers in Laurel, MS
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.