Wahid Mistikawi, D.M.D. P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

9368 Issued in SC

Practice address

4410 Highway 17 Unit B5
Murrells Inlet, SC 29576-6434

Phone

(843) 790-0950

Fax

(843) 947-0025

NPI assigned

Aug 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Great Woods Family Dentistry

  • General Practice Dentistry
  • Mansfield, MA
  • NPI 1841670262
  NPD (past) Authorized official

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1710135033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 SOUTH MAIN ST.",
            "address_2": "SUITE 24 GREATWOODS FAMILY OF COSMETIC DENTISTRY",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "02048",
            "telephone_number": "508-339-4171",
            "fax_number": "508-339-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 HIGHWAY 17 UNIT B5",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295766434",
            "telephone_number": "843-790-0950",
            "fax_number": "843-947-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTIKAWI",
        "first_name": "WAHID",
        "name_prefix": "Dr.",
        "credential": "D.M.D. P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "17639",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "9368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy Dale Miller Jr., PHARMD
• Keith S Miller
• Richard E Miller, CRNA
• Thomas Patrick Milling, RPH
• Angela Marie Mislowsky, MD
• Mobilityworks, LLC (MobilityWorks)
• Lauren Momper, PHARMD
• Timothy Montague-Smith
• James Claffy Montgomery Jr., M.D.
• Melissa Jo Moore, M.D.

• Dentist in Murrells Inlet, SC
• Providers in Murrells Inlet, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.