Sandra Marie Wilson

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH0000003997 Issued in TN

Practice address

1233 Southwest Ave
Johnson City, TN 37604-6596

Phone

(423) 979-4594

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sandra Marie Wilson Professional name

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205990561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 QUAIL RUN",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376015308",
            "telephone_number": "423-542-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 SOUTHWEST AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046596",
            "telephone_number": "423-979-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "DH0000003997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WILSON",
            "middle_name": "MARIE",
            "credential": "RDH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jim L Wilson, M.D.
• Joseph Wilson
• Megan Lorraine Wilson, NP
• Nathaniel Wilson, PHARM D.
• Robert Eugene Wilson, PMHNP
• Sydney N Wilson, NP
• Tonya Henry Wilson, ANP
• Tyler Keith Wilson, DO
• Andrew Steven Wilt, M.D.
• Matthew Wilton, DPT

• Dental Hygienist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Dental Hygienist in Tennessee

• 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.

Verify at the official NPI Registry.