Carl Clinton Wilkinson III, D.M.D., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9357 Issued in FL

Legal business name

CARL CLINTON WILKINSON III, D.M.D., P.A.

Doing business as

Clint Wilkinson, D.M.D., P.A.

Practice address

1300 W Eau Gallie Blvd
Suite B
Melbourne, FL 32935-5318

Phone

(321) 254-4111

Fax

(321) 254-0071

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carl Clinton Wilkinson III, D.M.D.

Title

President

Phone

(321) 254-4111

Specialties & licenses 1

Addresses

Other names 1

• Clint Wilkinson, D.M.D., P.A. Doing business as

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467546713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W EAU GALLIE BLVD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355318",
            "telephone_number": "321-254-4111",
            "fax_number": "321-254-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W EAU GALLIE BLVD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355318",
            "telephone_number": "321-254-4111",
            "fax_number": "321-254-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL CLINTON WILKINSON III, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "CLINTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-254-4111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "9357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clint Wilkinson, D.M.D., P.A.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Melbourne, FL
• Providers in Melbourne, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.