Organization Active NPI

D Neil Wilson D.D.S. M.S. PA

  • Endodontics
  • Vero Beach, FL
National Provider Identifier
1083867584
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN14498 Issued in FL
Legal business name
D NEIL WILSON D.D.S. M.S. PA
Practice address
2025 35TH Ave
Suite B
Vero Beach, FL 32960-2421
Phone
(772) 299-4179
Fax
(772) 299-4577
NPI assigned
Oct 28, 2008
Last updated
Oct 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Dr. Glenda M CaleyNPI 1851585640
Title
Secretary
Phone
(772) 299-4179

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN14498 FL Primary
Periodontics 1223P0300X DN16531 FL

Addresses

Primary practice location

2025 35TH Ave
Suite B
Vero Beach, FL 32960-2421

Mailing address

2025 35TH Ave
Suite B
Vero Beach, FL 32960-2421
Phone (772) 299-4179

National Provider Directory

National Provider Directory

Locations

2025 35th Ave
Ste B
Vero Beach, FL 32960
Phone (772) 299-4179

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1083867584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 35TH AVE",
            "address_2": "SUITE B",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329602421",
            "telephone_number": "772-299-4179",
            "fax_number": "772-299-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 35TH AVE",
            "address_2": "SUITE B",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329602421",
            "telephone_number": "772-299-4179",
            "fax_number": "772-299-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D NEIL WILSON D.D.S. M.S. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "CALEY",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "772-299-4179",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN14498",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN16531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.