Individual provider Active NPI

Herbert Skipper Wilson, DMD

  • Specialist
  • Montgomery, AL
National Provider Identifier
1093776536
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2941 Issued in AL
Practice address
4590 Woodmere Blvd
Montgomery, AL 36106-2918
Phone
(334) 271-2002
Fax
(334) 271-4523
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2941 AL Primary

Addresses

Primary practice location

4590 Woodmere Blvd
Montgomery, AL 36106-2918

Mailing address

4590 Woodmere Blvd
Montgomery, AL 36106-2918
Phone (334) 271-2002

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2941ALMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Oral & Maxillofacial Surgery LLC PastSince Jun 15, 1997 Accepting new patients
Alabama Surgical Arts, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093776536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062918",
            "telephone_number": "334-271-2002",
            "fax_number": "334-271-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062918",
            "telephone_number": "334-271-2002",
            "fax_number": "334-271-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "HERBERT",
        "middle_name": "SKIPPER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "2941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.