Individual provider Active NPI

Jon Sharp Wilkins, D.D.S., M.S.D.,P.A.

  • Prosthodontics
  • Winter Park, FL
National Provider Identifier
1467566349
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN6183 Issued in FL
Practice address
731 W Morse Blvd
Winter Park, FL 32789-3794
Phone
(407) 644-0177
Fax
(407) 644-8839
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DN6183 FL Primary

Addresses

Primary practice location

731 W Morse Blvd
Winter Park, FL 32789-3794

Mailing address

731 W Morse Blvd
Winter Park, FL 32789-3794
Phone (407) 644-0177

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
DN6183FLMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Jon S Wilkins, D.D.S., P.a. Prosthodontics Past Accepting new patients
R Mark Matar DMD PA PastSince Apr 19, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467566349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 W MORSE BLVD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893794",
            "telephone_number": "407-644-0177",
            "fax_number": "407-644-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 W MORSE BLVD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893794",
            "telephone_number": "407-644-0177",
            "fax_number": "407-644-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "JON",
        "middle_name": "SHARP",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN6183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.