Individual provider Active NPI

Wilson Wright Jr., DMD

  • Dentist
  • Birmingham, AL
National Provider Identifier
1154419026
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3138 Issued in AL
Practice address
524 Red Lane Rd
Suite F
Birmingham, AL 35215-8245
Phone
(205) 836-4044
Fax
(205) 836-4311
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3138 AL Primary

Addresses

Primary practice location

524 Red Lane Rd
Suite F
Birmingham, AL 35215-8245

Mailing address

524 Red Lane Rd
Suite F
Birmingham, AL 35215-8245
Phone (205) 410-6576

Other identifiers 1

IdentifierTypeStateIssuer
009968360MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160521000032 AL Order and Referring Only - DentistPractitioner - Dentist 0840589446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3138ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentist in Action Past Accepting new patients
Dentists in Action, PC 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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296691200000",
    "number": "1154419026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 RED LANE RD",
            "address_2": "SUITE F",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158245",
            "telephone_number": "205-410-6576",
            "fax_number": "205-836-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 RED LANE RD",
            "address_2": "SUITE F",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158245",
            "telephone_number": "205-836-4044",
            "fax_number": "205-836-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "3138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009968360",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.