Individual provider Active NPI

Jon W Tilton, DDS

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1225017973
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5152 Issued in KS
Practice address
404 S Edgemoor St
Suite 320
Wichita, KS 67218-1631
Phone
(316) 684-8440
Fax
(316) 686-7218
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5152 KS Primary

Addresses

Primary practice location

404 S Edgemoor St
Suite 320
Wichita, KS 67218-1631

Mailing address

404 S Edgemoor St
Suite 320
Wichita, KS 67218-1631
Phone (316) 684-8440

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

LicenseStateTypeSpecialty
5152KSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1225017973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S EDGEMOOR ST",
            "address_2": "SUITE 320",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181631",
            "telephone_number": "316-684-8440",
            "fax_number": "316-686-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S EDGEMOOR ST",
            "address_2": "SUITE 320",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181631",
            "telephone_number": "316-684-8440",
            "fax_number": "316-686-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "JON",
        "middle_name": "W",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

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.

Verify at the official NPI Registry.