Active NPI
J J Wilkerson, D.D.S.
- Pediatric Dentistry
- Reno, NV
National Provider Identifier
1205976719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 3068
- Practice address
- 10455 Double R Blvd
Dentistry for Kids
Reno, NV 89521-8905 - Phone
- (775) 823-9797
- NPI assigned
- Feb 7, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 3068 | NV | Primary |
Addresses
Primary practice location
10455 Double R Blvd
Dentistry for Kids
Reno, NV 89521-8905
Mailing address
10455 Double R Blvd
Dentistry for Kids
Reno, NV 89521-8905
Phone (775) 823-9797
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 |
|---|---|---|---|
| 3068 | NV | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205976719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10455 DOUBLE R BLVD",
"address_2": "DENTISTRY FOR KIDS",
"city": "RENO",
"state": "NV",
"postal_code": "895218905",
"telephone_number": "775-823-9797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10455 DOUBLE R BLVD",
"address_2": "DENTISTRY FOR KIDS",
"city": "RENO",
"state": "NV",
"postal_code": "895218905",
"telephone_number": "775-823-9797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "J",
"middle_name": "J",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NV",
"license": "3068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.