Justin Patrick Willson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12852 Issued in TN

Practice address

489 Forks of the River Pkwy
Sevierville, TN 37862-3422

Phone

(865) 453-0032

Fax

(865) 378-8636

NPI assigned

Jul 30, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• N/a N/a N/a Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Powell Family Dentistry

  • Dental Clinic/Center
  • Powell, TN
  • NPI 1669135646
  NPD
• Dr. Steve Madison & Associates

  • General Practice Dentistry
  • Sevierville, TN
  • NPI 1528224565
  NPD (past)
• Rocky Top Dental Services LLC

  • Dental Clinic/Center
  • Knoxville, TN
  • NPI 1265246557
  NPD (past)

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1083597603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 FORKS OF THE RIVER PKWY",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378623422",
            "telephone_number": "865-453-0032",
            "fax_number": "865-378-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 FORKS OF THE RIVER PKWY",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378623422",
            "telephone_number": "865-453-0032",
            "fax_number": "865-378-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "JUSTIN",
        "middle_name": "PATRICK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-30",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "middle_name": "N/A",
            "credential": "DR. WILLSON",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tracie Jennifer Widner, MA, CCC-SLP
• Derek Wiggins, PA-C
• Jamie T Williams, OTD, OTR/L
• Phyllis Susan Williams
• Kyle Walker Williamson
• Ginny Winters
• Wise Vision Care, PLLC
• Timothy Charles Wise, OD
• Timothy Charles Wise II, O.D.
• Matthew Hal Wolfenbarger

• Dentist in Sevierville, TN
• Providers in Sevierville, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.