NPIMap

Organization Active NPI

Wilson & Fiquett, D.M.D., P.C.

  • General Practice Dentistry
  • Fort Payne, AL
National Provider Identifier
1336239086
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WILSON & FIQUETT, D.M.D., P.C.
Practice address
110 23Rd St NW
Fort Payne, AL 35967-3671
Phone
(256) 845-0765
Fax
(256) 845-9895
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark Clinton Wilson, D.M.D.NPI 1316037039
Title
President
Phone
(256) 845-0765

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

110 23Rd St NW
Fort Payne, AL 35967-3671

Mailing address

110 23Rd St NW
Fort Payne, AL 35967-3671
Phone (256) 845-0765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150327000128 AL Part B Supplier - Clinic/Group Practice 3375860547 Receives reassigned benefits from 6 practitioners
Practice locations: Fort Payne, AL

National Provider Directory

National Provider Directory

Locations

110 23rd St NW
Fort Payne, AL 35967
Phone (256) 845-0765

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336239086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 23RD ST NW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673671",
            "telephone_number": "256-845-0765",
            "fax_number": "256-845-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 23RD ST NW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673671",
            "telephone_number": "256-845-0765",
            "fax_number": "256-845-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON & FIQUETT, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CLINTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-845-0765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.