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

Jay Wickersham

Individual provider Dentist · NPI 1285251389

Jay Wickersham is a Dentist in Riverview, Florida. Licensed in Florida. Registered with an NPI since 2020.

Licensed in
FL
In the registry since
2020
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Practice location Address checks out

12926 US Highway 301 S Ste 5
Riverview, FL 33578-7458
Phone: (217) 540-5100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DN25056 (FL)

Record details

NPI number1285251389
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 6, 2020
Last updated in NPPESJuly 6, 2020
Certification dateJuly 6, 2020
Mailing address12926 Us Highway 301 S Ste 5, Riverview, FL 33578-7458

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