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 provides Dentist services 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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