Individual provider Active NPI

Emmett E Wilson, DDS

  • General Practice Dentistry
  • Hartford, CT
National Provider Identifier
1275503252
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5498 Issued in CT
Practice address
1453 Albany Ave
Hartford, CT 06112-2110
Phone
(860) 727-8146
Fax
(860) 241-0564
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5498 CT Primary

Addresses

Primary practice location

1453 Albany Ave
Hartford, CT 06112-2110

Mailing address

1453 Albany Ave
Hartford, CT 06112-2110
Phone (860) 727-8146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160613001215 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1759671225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
We Care Family Dental Center General Practice Past Accepting new patients

Organizations & group practices 1

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275503252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061122110",
            "telephone_number": "860-727-8146",
            "fax_number": "860-241-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061122110",
            "telephone_number": "860-727-8146",
            "fax_number": "860-241-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "EMMETT",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.