Kimberly Wiley, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106809 Issued in CA

Practice address

6226 E Spring St Ste 350
Long Beach, CA 90815-1447

Phone

(562) 425-5511

NPI assigned

Aug 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Dentist

Education

Univ of Pennsylvania School of Dental Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73477
• Direct secure messaging: kwiley731020@direct.ochin.org

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.

• Fulbright Dental Group, PC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1336384619
  Medicare reassignment
• Mountain Valleys Health Centers

  • Federally Qualified Health Center (FQHC)
  • Dorris, CA
  • NPI 1013088582
  NPD (past)

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1306511555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5464 E 4TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908141923",
            "telephone_number": "562-357-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 E SPRING ST STE 350",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151447",
            "telephone_number": "562-425-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya Wigington
• Timothy Michael Wiher
• Marta E Wild, MD
• Sara Wilde
• Elizabeth Wildermuth
• Michelle Wiley
• Nathan Corcoran Wilkes, M.D.
• Christopher Wilkins
• Jennifer Latrice Wilkins
• Cameron Wilkinson, MD, MBA

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.