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Contact Information

JESS W MIKESELL, DDS
1024 JONAS AVE
CENTRALIA, IL62801
 Phone: 618-533-2107
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JESS W MIKESELL · (Male)

NPI # 1841311024
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 04/03/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • IL License # 319 009068 019019675
  • MO License # 014683
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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