Lewis a. Wilk, DMD, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

018990-L Issued in PA

Legal business name

LEWIS A. WILK, DMD, PC

Practice address

1101 N Fifth St
Stroudsburg, PA 18360

Phone

(570) 421-3512

Fax

(570) 420-8134

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lewis A. Wilk, D.M.D.

Title

Owner

Phone

(570) 421-3512

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1417080797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N FIFTH ST",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "18360",
            "telephone_number": "570-421-3512",
            "fax_number": "570-420-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N FIFTH ST",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "18360",
            "telephone_number": "570-421-3512",
            "fax_number": "570-420-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS A. WILK, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "WILK",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-421-3512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "018990-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "081994",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Stroudsburg, PA
• Providers in Stroudsburg, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.