DR. WENDELL WAYNE NEELEY II (NPI# 1285806810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285806810 |
| Entity Type | Individual |
| Full Name | DR. WENDELL WAYNE NEELEY II |
| Credential | DMD, MD, MS |
| Practice Address |
1501 Kings Hwy Shreveport LA 71103-4228 |
| Mailing Address |
706 Delaware St Shreveport LA 71106-1640 |
| Practice Telephone | 3188132625 |
| Mailing Telephone | 2103782475 |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2014-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
S-800 | LA | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
20792 | TX | Dental Providers |
| Street Address |
1501 KINGS HWY |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890769 | F Dean Griffen | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-06-09 |
| 1336747625 | Lana Nasief | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-09 |
| 1558968834 | Dinesh Regalla | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-08 |
| 1588261283 | Divleen Sidhu | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-06 |
| 1023624517 | Grace Hoffman | Pharmacist | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-20 |
| 1194330761 | Yousef Hasan | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1790399277 | Ricardo Murguia Fuentes | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1013521509 | Tahir Ahmad | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1376155309 | Ayesha Malik | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-20 |
| 1104438324 | Elleny Gutierrez | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103 | 2020-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588078224 | Ricardo Lugo | Dentist | 1501 Kings Hwy Rm 530, Shreveport, LA 71103-4228 | 2014-06-19 |
| 1548427693 | David Kyle Clark | Dentist | 2120 Bert Kouns Loop Ste D, Shreveport, LA 71118-3351 | 2008-05-16 |
| 1801931209 | Walter Joseph James | Dentist | 915 Shreveport Barksdale Hwy, Shreveport, LA 71105-2205 | 2007-02-21 |
| 1194731836 | James William Sikes Jr. | Dentist | 6912 Fern Loop Ste A, Shreveport, LA 71105-4176 | 2006-08-01 |
| 1639191182 | Brian Roy Smith | Dentist | 2125 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5314 | 2006-07-24 |
| 1750347498 | Jason Harold Lustig | Dentist | 7600 Fern Ave, Building 1400, Shreveport, LA 71105-5659 | 2006-04-21 |
| 1104095520 | Celso Fernando Palmieri | Dentist | 1501 Kings Hwy, Department of Oral Surgery, Shreveport, LA 71103-4228 | 2008-02-29 |
| 1003092545 | Arklatex Oral & Maxillofacial Surgery A Partnership of Professional De | Dentist | 7600 Fern Ave, Building 1400, Shreveport, LA 71105-5659 | 2008-01-15 |
| 1326188145 | William Brantley Goyne | Dentist | 2001 E 70th St, Suite 606, Shreveport, LA 71105-5328 | 2007-02-08 |
| 1821016957 | Dongsoo David Kim | Dentist | 1501 Kings Hwy, Department of Oral Surgery, Shreveport, LA 71103-4228 | 2006-07-17 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.