Dembe Wilson

Primary specialty

SpecialistTaxonomy code 174400000X

License

040668 Issued in NY

Practice address

3030 Westchester Ave
Purchase, NY 10577-2574

Phone

(914) 682-6435

Fax

(914) 681-3115

NPI assigned

Dec 27, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: demwilson@hiemail.healtheconnections.org

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083159230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772547",
            "telephone_number": "914-607-5730",
            "fax_number": "914-457-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772574",
            "telephone_number": "914-682-6435",
            "fax_number": "914-681-3115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Westchester Ave",
            "address_purpose": "LOCATION",
            "city": "Purchase",
            "state": "NY",
            "postal_code": "105772547",
            "country_code": "US",
            "telephone_number": "914-607-5726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 Westchester Ave",
            "address_purpose": "LOCATION",
            "city": "Purchase",
            "state": "NY",
            "postal_code": "105772547",
            "country_code": "US",
            "telephone_number": "914-607-5726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEMBE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "040668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04783024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lora M Wells, OTR /L
• Westchester Oral & Maxillofacial Surgery & Implantology
• Olivia Wice
• Steven Ray Wilkening, MD, MS
• Gazaria C Williams, LMHC CABA
• Katherine Estelle Wolff, PT
• Carol Lynn Wurzel, MD
• Jacqueline E Wyman, MS, RD, CDN
• Irene Yu, MD
• Linda Yue, M.D.

• Specialist in Purchase, NY
• Providers in Purchase, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.