John Joseph Wilson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D-4649 Issued in ID

Practice address

2005 Pine St
Sandpoint, ID 83864-9327

Phone

(208) 263-8535

Fax

(208) 265-2365

NPI assigned

Jul 30, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• John Wilson DDS, PLLC

  • Dentist
  • Sandpoint, ID
  • NPI 1184006074
  NPD Authorized official

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1205182003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 PINE ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838649327",
            "telephone_number": "208-263-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 PINE ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838649327",
            "telephone_number": "208-263-8535",
            "fax_number": "208-265-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60289676",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wildflower Spa at Seasons
• Thomas Marvin Wiley, OD
• Brianna Madeline Williams
• Chase C Williams, MD
• Kaitlin Elizabeth Williams, M.S.
• Winona Lee Wilson
• Susanne Wimberley, LMSW
• Shaundi Ann Wolfe-Weaver, LAMFT
• Carla Roxann Wolfrum, LD
• Michelle Woodward, LPC, NCC

• Dentist in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.