NPIMap

Organization Active NPI

Wilson Family Dentistry

  • Dentist
  • Selmer, TN
National Provider Identifier
1003278367
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3832 Issued in TN
Legal business name
WILSON FAMILY DENTISTRY
Practice address
710 Federal Dr
Selmer, TN 38375-1876
Phone
(731) 645-7506
Fax
(731) 645-5660
NPI assigned
Mar 25, 2016
Last updated
Mar 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christina King
Title
Office Manager
Phone
(731) 645-7506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3832 TN Primary

Addresses

Primary practice location

710 Federal Dr
Selmer, TN 38375-1876

Mailing address

710 Federal Dr
Selmer, TN 38375-1876
Phone (731) 645-7506

National Provider Directory

National Provider Directory
Tax ID family
Dr Greg L Wilson Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1003278367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 FEDERAL DR",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383751876",
            "telephone_number": "731-645-7506",
            "fax_number": "731-645-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 FEDERAL DR",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383751876",
            "telephone_number": "731-645-7506",
            "fax_number": "731-645-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "731-645-7506"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "3832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selmer, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.