Active NPI
David A King, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Wilmington, DE
National Provider Identifier
1417083627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- G1-0001107
- Practice address
- 1304 N Broom St
Wilmington, DE 19806-4266 - Phone
- (302) 655-6183
- Fax
- (302) 998-5410
- NPI assigned
- Feb 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | G1-0001107 | DE | Primary |
Addresses
Primary practice location
1304 N Broom St
Wilmington, DE 19806-4266
Mailing address
1304 N Broom St
Wilmington, DE 19806-4266
Phone (302) 655-8717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G1-0001107 | DE | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1417083627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 N BROOM ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198064266",
"telephone_number": "302-655-8717",
"fax_number": "803-691-6825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 N BROOM ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198064266",
"telephone_number": "302-655-6183",
"fax_number": "302-998-5410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "DAVID",
"middle_name": "A",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-24",
"last_updated": "2024-07-09",
"certification_date": "2024-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "DE",
"license": "G1-0001107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.