Provider Demographics
NPI:1760653034
Name:DAWKINS, WARD EDWIN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WARD
Middle Name:EDWIN
Last Name:DAWKINS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 N LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-3209
Mailing Address - Country:US
Mailing Address - Phone:662-234-5725
Mailing Address - Fax:662-234-4811
Practice Address - Street 1:440 N LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-3209
Practice Address - Country:US
Practice Address - Phone:662-234-5725
Practice Address - Fax:662-234-4811
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS26681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06587505Medicaid