Elizabeth Brooke Wilcox

Primary specialty

DentistTaxonomy code 122300000X

License

13395841-9922 Issued in UT

Practice address

1060 W Park LN Ste 110
Farmington, UT 84025-2994

Phone

(801) 797-0069

NPI assigned

Mar 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1477203859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16124 HOWARD LANDING DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782262",
            "telephone_number": "301-300-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PARK LN STE 110",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252994",
            "telephone_number": "801-797-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "ELIZABETH",
        "middle_name": "BROOKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "13395841-9926",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "13395841-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Joy Wetherwax, SLP
• Noelle Faith Whitaker
• Joanna M White, LMT
• Miriam Whitear, RBT
• Stuart Wilcock
• Brenna Williams, RBT
• Robin Renee Williams, MSW, LCSW
• Richard Blair Willis, M.D.
• Marianne Margaret Wilson
• Linda Winn, CCC-SLP

• Dentist in Farmington, UT
• Providers in Farmington, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.