John Thornton Wilson, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-1449 Issued in ID

Practice address

10497 W Garverdale CT
Suite 107
Boise, ID 83704-5407

Phone

(208) 375-5720

Fax

(208) 323-8538

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wilson Dental PLLC

  • Dental Clinic/Center
  • Boise, ID
  • NPI 1265935902
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386717213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 N MARCLIFFE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837042058",
            "telephone_number": "208-375-5631",
            "fax_number": "208-323-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10497 W GARVERDALE CT",
            "address_2": "SUITE 107",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045407",
            "telephone_number": "208-375-5720",
            "fax_number": "208-323-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "THORNTON",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-1449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Guthrie Wilson, PAC
• Ivy Meg Wilson, PA-C
• James Brett Wilson, D.O.
• Jennifer A. Wilson, C.S.T.
• Jennifer Anne Wilson
• Jordan Finnegan Wilson, PA-C
• Karen Wilson, PT, DPT
• Katie Joy Wilson, LMSW
• Kevin William Wilson, DO
• Kiley Wilson, RN

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.