Chester A. Wilson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19531 Issued in OH

Practice address

2205 Tuscarawas St E
Canton, OH 44707-2702

Phone

(330) 453-7299

Fax

(330) 453-7282

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114940715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 TUSCARAWAS ST E",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447072702",
            "telephone_number": "330-453-7299",
            "fax_number": "330-453-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 TUSCARAWAS ST E",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447072702",
            "telephone_number": "330-453-7299",
            "fax_number": "330-453-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHESTER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "19531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880757",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2373",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34-1825962028",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey Y. Wilson, BA, TO
• Betty-Jo Wilson, QMHS
• Billie Wilson, COTA/L
• Candyce Kay Wilson, LPCC-S
• Charlyda Wilson, QMHS
• Elizabeth R Wilson, LPN
• Gail A Wilson, RN
• James R Wilson, M.D.
• Katie Lynn Wilson, LPN
• Taylor Wilson

• General Practice Dentistry in Canton, OH
• Providers in Canton, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.