Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ollie Hardaway Jr., DDS

Individual provider Dentist · NPI 1063539138

Dr. Ollie Hardaway Jr., DDS is a Dentist in Vicksburg, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.

Licensed in
MS
In the registry since
2007
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

154 Cottonwood St
Vicksburg, MS 39180
Phone: (662) 873-4593
Fax: (662) 873-4112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 180178 (MS)
General Practice Dentistry Taxonomy 1223G0001X · Licence 180178 (MS)

Record details

NPI number1063539138
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMarch 23, 2007
Last updated in NPPESDecember 17, 2007

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