Dr. Joseph a. Wilson DMD, MSD, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DD3399 Issued in NM

Legal business name

DR. JOSEPH A. WILSON DMD, MSD, LLC

Practice address

4760 N Butler Ave Ste a
Farmington, NM 87401-0816

Phone

(702) 469-3590

Fax

(702) 469-3590

NPI assigned

Mar 29, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Joseph A Wilson, DMD MSD LLC

Title

Owner

Phone

(702) 469-3590

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1417246562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVESUITE A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87401",
            "telephone_number": "702-469-3590",
            "fax_number": "702-469-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVE STE A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010816",
            "telephone_number": "702-469-3590",
            "fax_number": "702-469-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOSEPH A. WILSON DMD, MSD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-469-3590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MSD LLC"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NM",
            "license": "DD3399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Farmington, NM by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.