Active NPI
Roger Alan Wright, D. M. D.
- Dentist
- Aberdeen, MS
National Provider Identifier
1669560405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1860-79
- Practice address
- 513 W Commerce St
Aberdeen, MS 39730-2543 - Phone
- (662) 369-2063
- Fax
- (662) 369-2076
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1860-79 | MS | Primary |
Addresses
Primary practice location
513 W Commerce St
Aberdeen, MS 39730-2543
Mailing address
PO Box 212
Aberdeen, MS 39730-0212
Phone (662) 369-2063
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00064708 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1860-79 | MS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348444800000",
"number": "1669560405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 212",
"city": "ABERDEEN",
"state": "MS",
"postal_code": "397300212",
"telephone_number": "662-369-2063",
"fax_number": "662-369-2076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 W COMMERCE ST",
"city": "ABERDEEN",
"state": "MS",
"postal_code": "397302543",
"telephone_number": "662-369-2063",
"fax_number": "662-369-2076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "ROGER",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D. M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2012-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "1860-79",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00064708",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.