Roger Cave Wilson, DDS, MS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

M367 Issued in SD

Practice address

3415 5TH St
Rapid City, SD 57701-7365

Phone

(605) 348-6818

Fax

(605) 348-4690

NPI assigned

Feb 27, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1437125721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017365",
            "telephone_number": "605-348-6818",
            "fax_number": "605-348-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017365",
            "telephone_number": "605-348-6818",
            "fax_number": "605-348-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROGER",
        "middle_name": "CAVE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "SD",
            "license": "M367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000050",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joleen Wilson, P.T.
• Jonathan Lee Wilson, M.D.
• Joslin Teresa Wilson
• Matthew Donald Wilson, DPT
• Robert Bruce Wilson, OD
• Thomas Wilson, M.D.
• Tina Marie Wilson
• Jon Mathias Wingert, MD
• Ray A Winsel, R.PH
• Deborah Kay Winter, PA-C

• Oral and Maxillofacial Pathology Dentistry in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Oral and Maxillofacial Pathology Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.