Raymond Carl Wilbur Sr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D10169 Issued in MN

Practice address

108 N 3Rd Ave
Virginia, MN 55792-2519

Phone

(218) 741-9251

Fax

(218) 741-1747

NPI assigned

Mar 16, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Dental Associates of Virginia PC

  • Dentist
  • Virginia, MN
  • NPI 1881192755
  NPD (past)
• Dental Associates, LTD.

  • General Practice Dentistry
  • Virginia, MN
  • NPI 1174751531
  NPD (past)

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477794857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1247",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557921247",
            "telephone_number": "218-741-9251",
            "fax_number": "218-741-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N 3RD AVE",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922519",
            "telephone_number": "218-741-9251",
            "fax_number": "218-741-1747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4325 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558072730",
            "country_code": "US",
            "telephone_number": "218-628-7035",
            "fax_number": "218-624-6594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILBUR",
        "first_name": "RAYMOND",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "10169",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White Drug Enterprises Inc
• Alexis White
• Audrey S White
• David Howard Wicker
• Mark Francis Wicker
• Brianna Williams
• Jacob Donald Williams
• Dequan Shaon Wilson
• Rachel E Wilson
• Archie Chance Winans, DPT

• Dentist in Virginia, MN
• Providers in Virginia, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.