Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Roger Wirtz DMD PA

Organization Dentist · NPI 1861564817

Roger Wirtz DMD PA is a Dentist in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1765 Lelia Dr
Jackson, MS 39216-4820
Phone: (601) 982-5349
Fax: (601) 982-9084
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 204083 (MS)

Record details

NPI number1861564817
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Wirtz — President · (601) 982-5349
NPI enumeratedNovember 14, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1765 Lelia Drive, Jackson, MS 39216-4820

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