Wgo Dental, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

WGO DENTAL, LLC

Doing business as

VIP Smiles Orthodontics

Practice address

5858 Ridgewood Rd
Jackson, MS 39211-2617

Phone

(601) 594-9202

NPI assigned

Oct 19, 2022

Last updated

Oct 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clora Evans, DMDNPI 1740835529

Title

Owner

Phone

(601) 594-9202

Specialties & licenses 1

Addresses

Other names 1

• VIP Smiles Orthodontics Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clora Jamie O'Reilly Evans, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Meridian, MS
  • NPI 1740835529
  NPD Authorized official

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1912623141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 RIDGEWOOD RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112617",
            "telephone_number": "601-594-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5858 RIDGEWOOD RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112617",
            "telephone_number": "601-594-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WGO DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CLORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-594-9202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIP Smiles Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Collins West, PT, DPT
• Sydney Nichole West, MD
• Alex Westbrook, RN
• David Westbrook, M.D.
• Michael G Weston
• Diana J Whalen
• James Zebedee Whatley IV, M.D.
• Sherman Anthony Wheat, CRNA
• Myra A Wheaton, M.D. , M.P.H.
• James Herman Whelan, RPH

• Orthodontics and Dentofacial Orthopedics Dentistry in Jackson, MS
• Providers in Jackson, MS by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.