NPIMap

Organization Active NPI

Carol a. Wilson, DMD, PLLC

Doing business as Jessamine Dental

  • Dentist
  • Nicholasville, KY
National Provider Identifier
1114299047
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8377 Issued in KY
Legal business name
CAROL A. WILSON, DMD, PLLC
Doing business as
Jessamine Dental
Practice address
100 Lake St
Nicholasville, KY 40356-1002
Phone
(859) 885-5703
Fax
(859) 885-5703
NPI assigned
Feb 8, 2012
Last updated
Feb 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Authorized official

Name
Dr. Carol Ann Wilson, DMDNPI 1114054541
Title
Dentist/Owner
Phone
(859) 885-5703

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
Dentist 122300000X 8377 KY Primary
General Practice Dentistry 1223G0001X 8377 KY

Addresses

Primary practice location

100 Lake St
Nicholasville, KY 40356-1002

Mailing address

100 Lake St
Nicholasville, KY 40356-1002
Phone (859) 885-5703

Other identifiers 1

IdentifierTypeStateIssuer
7100094910MedicaidKY

Other names 1

  • Jessamine Dental Doing business as

National Provider Directory

National Provider Directory

Locations

100 Lake St
Nicholasville, KY 40356
Phone (859) 885-5703

Practitioners & affiliated clinicians

Practitioners 1

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": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1114299047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LAKE ST",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403561002",
            "telephone_number": "859-885-5703",
            "fax_number": "859-885-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LAKE ST",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403561002",
            "telephone_number": "859-885-5703",
            "fax_number": "859-885-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL A. WILSON, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "859-885-5703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8377",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8377",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100094910",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jessamine Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nicholasville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.