Wilson DMD a Professional Dental Corporation

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WILSON DMD A PROFESSIONAL DENTAL CORPORATION

Practice address

933 Shasta St
Yuba City, CA 95991-4114

Phone

(530) 671-1770

NPI assigned

Jun 5, 2024

Organization subpart

No

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

Authorized official

Name

Krystal Castillo

Title

Coordinator

Phone

(972) 689-8630

Specialties & licenses 2

Addresses

Other names 1

• Magnolia Sleep Solutions Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alan Daniel Reid, DMD

  • Dentist
  • Yuba City, CA
  • NPI 1457666216
  NPD
• Spencer William Wilson

  • General Practice Dentistry
  • Yuba City, CA
  • NPI 1952618142
  NPD

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1003657669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 SHASTA ST",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959914114",
            "telephone_number": "530-671-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 SHASTA ST",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959914114",
            "telephone_number": "530-671-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON DMD A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "972-689-8630"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Sleep Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Sleep Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John J Willis, PA-C
• Willow Glen Care Center
• Willow Glen Care Center
• Willow Glen Care Center
• Willow Glen Care Center
• Amber Wilson
• Laura F. Wilson, LMFT
• Mary Wilson, MENTAL HEALTH WORKER
• Spencer William Wilson
• Amy Wirth, L.P.T

• Durable Medical Equipment & Medical Supplies in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.