Individual provider Active NPI

Jake Thomas Wilding, D.D.S

  • Prosthodontics
  • Fort Cavazos, TX
National Provider Identifier
1376975680
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
8726975-9922 Issued in UT
Practice address
US Army Dental Health Activity
36000 Shoemaker Lane, Suite 1051
Fort Cavazos, TX 76544-7654
Phone
(254) 287-3105
NPI assigned
Aug 9, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39234 TX
Prosthodontics 1223P0700X 8726975-9922 UT Primary
Dentist 122300000X 8726975-9922 UT
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 39234 TX

Addresses

Primary practice location

US Army Dental Health Activity
36000 Shoemaker Lane, Suite 1051
Fort Cavazos, TX 76544-7654

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Other practice location 1

2401 S 31st St
Temple, TX 76508-0001
Phone (254) 724-2111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilding1371960@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241127002165 TX Practitioner - DentistPractitioner - Oral Surgery 7214462274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Oral Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39234TXMDPsychologist
8726975-9922UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Nov 13, 2024 Accepting new patients
Scott and White Clinic CurrentSince Nov 13, 2024 Accepting new patients
Scott & White Clinic Current Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Eisenhower Army Medical Center PastSince Nov 1, 2019 Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1376975680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US ARMY DENTAL HEALTH ACTIVITY",
            "address_2": "36000 SHOEMAKER LANE, SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765447654",
            "telephone_number": "254-287-3105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDING",
        "first_name": "JAKE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-09",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "39234",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "UT",
            "license": "8726975-9922",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "8726975-9922",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "39234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilding1371960@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Cavazos, TX

Sources for this page

Verify at the official NPI Registry.