Healthcare Provider Details

I. General information

NPI: 1669810040
Provider Name (Legal Business Name): EMILY D WILHITE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 LAKE VILLAGE CIR
BRANDON MS
39047-6743
US

IV. Provider business mailing address

1075 LAKE VILLAGE CIR
BRANDON MS
39047-6743
US

V. Phone/Fax

Practice location:
  • Phone: 601-992-1605
  • Fax:
Mailing address:
  • Phone: 601-992-1605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4145
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: