Active NPI
Emily Jo Wilson, DDS
- General Practice Dentistry
- Little Rock AFB, AR
National Provider Identifier
1386342434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 39839
- Practice address
- 1020 Arnold Dr
Little Rock AFB, AR 72099-1809 - Phone
- (501) 987-9811
- NPI assigned
- Feb 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 39839 | TX | Primary |
Addresses
Primary practice location
1020 Arnold Dr
Little Rock AFB, AR 72099-1809
Mailing address
1020 Arnold Dr
Little Rock AFB, AR 72099-1809
Phone (501) 987-4067
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251014004441 | TX | Order and Referring Only - Dentist | 6406343342 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39839 | TX | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781740800000",
"number": "1386342434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 ARNOLD DR",
"city": "LITTLE ROCK AFB",
"state": "AR",
"postal_code": "720991809",
"telephone_number": "501-987-4067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 ARNOLD DR",
"city": "LITTLE ROCK AFB",
"state": "AR",
"postal_code": "720991809",
"telephone_number": "501-987-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "EMILY",
"middle_name": "JO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-17",
"last_updated": "2026-06-18",
"certification_date": "2026-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "39839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock AFB, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.