Individual provider Active NPI

Nicholas Wilken, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Baltimore, MD
National Provider Identifier
1467845214
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
16096 Issued in MD
Practice address
650 W Baltimore St
1St Floor Suite 1401
Baltimore, MD 21201-1510
Phone
(410) 706-6195
NPI assigned
Mar 17, 2015
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 16096 MD Primary

Addresses

Primary practice location

650 W Baltimore St
1St Floor Suite 1401
Baltimore, MD 21201-1510

Mailing address

613 S Fremont Ave
Baltimore, MD 21230-2429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005000090 MD Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 4789981523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
University of Maryland School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

650 W Baltimore St
Suite 1401
Baltimore, MD 21201-1510
Phone (410) 706-6195

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16096MDMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Oral Maxillofacial Surgery Assoc PA Oral and Maxillofacial Surgery CurrentSince Aug 24, 2021 Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients

Locations

650 W Baltimore St
Ste 1401
Baltimore, MD 21201
Phone (410) 706-6195

Interoperability endpoints

  • Direct secure messaging: nwilken220748@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1467845214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 S FREMONT AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212302429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST",
            "address_2": "1ST FLOOR SUITE 1401",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKEN",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-17",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "16096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.