Individual provider Active NPI

Robert McLain Wilkinson Jr., D.D.S.

  • General Practice Dentistry
  • Winston Salem, NC
National Provider Identifier
1306903760
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5784 Issued in NC
Practice address
1900 S Hawthorne Rd
Suite 170
Winston Salem, NC 27103-3913
Phone
(336) 765-9247
Fax
(336) 765-6960
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

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 5784 NC Primary

Addresses

Primary practice location

1900 S Hawthorne Rd
Suite 170
Winston Salem, NC 27103-3913

Mailing address

1900 S Hawthorne Rd
Suite 170
Winston Salem, NC 27103-3913
Phone (336) 765-9247

Other identifiers 1

IdentifierTypeStateIssuer
8999290MedicaidNC

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

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306903760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S HAWTHORNE RD",
            "address_2": "SUITE 170",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033913",
            "telephone_number": "336-765-9247",
            "fax_number": "336-765-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S HAWTHORNE RD",
            "address_2": "SUITE 170",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033913",
            "telephone_number": "336-765-9247",
            "fax_number": "336-765-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "ROBERT",
        "middle_name": "MCLAIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8999290",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

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.

Verify at the official NPI Registry.