Active NPI
Robert James Wilson, DDS
- General Practice Dentistry
- McKinney, TX
National Provider Identifier
1013140672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 58576
- Practice address
- 1321 N Tennessee St
# 108
McKinney, TX 75069-2142 - Phone
- (469) 742-0793
- NPI assigned
- Aug 31, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 58576 | CA | Primary |
| General Practice Dentistry | 1223G0001X | 25145 | TX |
Addresses
Primary practice location
1321 N Tennessee St
# 108
McKinney, TX 75069-2142
Mailing address
1920 Grassmere LN
Apt 331
McKinney, TX 75071-8519
Phone (714) 717-8910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25145 | TX | MD | Social Worker |
| 58576 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1013140672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 GRASSMERE LN",
"address_2": "APT 331",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750718519",
"telephone_number": "714-717-8910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 N TENNESSEE ST",
"address_2": "# 108",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750692142",
"telephone_number": "469-742-0793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROBERT",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-31",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "58576",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "25145",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.