Active NPI
Thomas G. Wilson Jr., D.D.S.
- Periodontics
- Dallas, TX
National Provider Identifier
1124011002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 9710
- Practice address
- 5465 Blair Rd
Suite 200
Dallas, TX 75231-4100 - Phone
- (214) 691-2404
- Fax
- (214) 691-2228
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 9710 | TX | Primary |
Addresses
Primary practice location
5465 Blair Rd
Suite 200
Dallas, TX 75231-4100
Mailing address
5465 Blair Rd
Suite 200
Dallas, TX 75231-4100
Phone (214) 691-2404
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9710 | TX | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Dallas Dental Health PLLC | Periodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Periodontics
- Dallas, TX
- NPI 1295124667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124011002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5465 BLAIR RD",
"address_2": "SUITE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314100",
"telephone_number": "214-691-2404",
"fax_number": "214-691-2228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5465 BLAIR RD",
"address_2": "SUITE 200",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314100",
"telephone_number": "214-691-2404",
"fax_number": "214-691-2228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "THOMAS",
"middle_name": "G.",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "9710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
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.