Active NPI
Karli Lynn Wilson, DMD
- Dentist
- Bountiful, UT
National Provider Identifier
1033858782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13047862-9922
- Practice address
- 24 S 500 W
Bountiful, UT 84010-7187 - Phone
- (801) 296-1606
- NPI assigned
- Jun 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13047862-9922 | UT | Primary |
Addresses
Primary practice location
24 S 500 W
Bountiful, UT 84010-7187
Mailing address
24 S 500 W
Bountiful, UT 84010-7187
Phone (801) 296-1606
Other practice location 1
4019 W 12600 S Ste 100
Riverton, UT 84096-7402
Phone (801) 253-8633
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 |
|---|---|---|---|
| 13047862-9922 | UT | MD | Dentist |
Networks
- UT PPO D-SNP
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1033858782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 S 500 W",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840107187",
"telephone_number": "801-296-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 S 500 W",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840107187",
"telephone_number": "801-296-1606"
}
],
"practiceLocations": [
{
"address_1": "4019 W 12600 S Ste 100",
"address_purpose": "LOCATION",
"city": "Riverton",
"state": "UT",
"postal_code": "840967402",
"country_code": "US",
"telephone_number": "801-253-8633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "KARLI",
"middle_name": "LYNN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-01",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "13047862-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bountiful, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.