# DR. TERESA MIXON PERKINS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1164579504
- **Gender:** F
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 242188 | MS | Yes |
| 1223P0221X | Pediatric Dentistry | 4749 | LA | — |
| 1223P0221X | Pediatric Dentistry | PEDO16589 | MS | — |

## Other

- **Enumeration date:** 01/05/2007
- **Last updated:** 09/19/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02058365 | — | MS |
| 05 | — | 1847496 | — | LA |