Individual provider Active NPI

Ronald Carl Wilcox, D.D.S.

  • General Practice Dentistry
  • Peachtree City, GA
National Provider Identifier
1114922382
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
009989 Issued in GA
Practice address
1235 Robinson Rd
Ste H
Peachtree City, GA 30269-3832
Phone
(770) 487-1880
Fax
(770) 487-1851
NPI assigned
Jun 15, 2005
Last updated
Jul 13, 2026By the provider in NPPES
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
General Practice Dentistry 1223G0001X 009989 GA Primary

Addresses

Primary practice location

1235 Robinson Rd
Ste H
Peachtree City, GA 30269-3832

Mailing address

1235 Robinson Rd
Ste H
Peachtree City, GA 30269-3832
Phone (770) 487-1880

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

State licenses

LicenseStateTypeSpecialty
009989GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Lane Ga Partners LLC General Practice PastSince Nov 30, 2025 Accepting new patients
Bird Kind LLC General Practice PastSince Nov 30, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114922382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 ROBINSON RD",
            "address_2": "STE H",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693832",
            "telephone_number": "770-487-1880",
            "fax_number": "770-487-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 ROBINSON RD",
            "address_2": "STE H",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693832",
            "telephone_number": "770-487-1880",
            "fax_number": "770-487-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "RONALD",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "009989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

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.