Individual provider Active NPI

W Ron Wilson, DDS

  • General Practice Dentistry
  • Chico, CA
National Provider Identifier
1356332530
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46446 Issued in CA
Practice address
8 Governors LN
Chico, CA 95926-1990
Phone
(530) 877-7661
Fax
(530) 877-7702
NPI assigned
Nov 4, 2005
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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 46446 CA Primary

Addresses

Primary practice location

8 Governors LN
Chico, CA 95926-1990

Mailing address

8 Governors LN
Chico, CA 95926-1990
Phone (530) 877-7661

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605001398 CA Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 9234119280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46446CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ron Wilson, D.D.S. Inc. CurrentSince Jan 12, 2020 Accepting new patients

Locations

8 Governors Ln
Chico, CA 95926
Phone (530) 877-7661

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1356332530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GOVERNORS LN",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261990",
            "telephone_number": "530-877-7661",
            "fax_number": "530-877-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GOVERNORS LN",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261990",
            "telephone_number": "530-877-7661",
            "fax_number": "530-877-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "W",
        "middle_name": "RON",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.