NPIMap

Organization Active NPI

Heather Wilson DDS LLC

  • General Practice Dentistry
  • Springfield, MO
National Provider Identifier
1386218824
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HEATHER WILSON DDS LLC
Practice address
3111 S Kimbrough Ave
Springfield, MO 65807-5011
Phone
(417) 887-5661
NPI assigned
May 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Dr. Heather Wilson, DDSNPI 1376031518
Title
Owner Dentist
Phone
(417) 234-2930

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

3111 S Kimbrough Ave
Springfield, MO 65807-5011

Mailing address

3111 S Kimbrough Ave
Springfield, MO 65807-5011
Phone (417) 887-5661

Other names 1

  • Kimbrough Dental Associates Doing business as

National Provider Directory

National Provider Directory

Locations

3111 S Kimbrough Ave
Springfield, MO 65807
Phone (417) 887-5661

Practitioners & affiliated clinicians

Practitioners 4

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": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1386218824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 S KIMBROUGH AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075011",
            "telephone_number": "417-887-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 S KIMBROUGH AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075011",
            "telephone_number": "417-887-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER WILSON DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "417-234-2930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimbrough Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.