Erin Riley Wilson, DMD

Individual provider Active NPI Pediatric Dentistry · Vineyard, UT

NPI 1497115117 · NPPES record last updated Feb 27, 2020

Key facts

NPI
1497115117
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
11502390 (UT)
Practice address
707 E Mill Rd Ste 101
Vineyard, UT 84059-5732
Phone
(801) 655-5900
NPI assigned
Feb 24, 2016
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11502390UTMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Allencrane, LLP Pediatric Dentistry Past Accepting new patients
Abc Pediatric Dentistry, PC Pediatric Dentistry Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 11502390 UT Yes

Addresses

Primary practice location

707 E Mill Rd Ste 101
Vineyard, UT 84059-5732

Mailing address

707 E Mill Rd Ste 101
Vineyard, UT 84059-5732
Phone (801) 655-5900

Other practice location 1

65 N Gateway Dr Ste 1
Providence, UT 84332-6102
Phone (435) 787-2223

Other providers in Vineyard, UT

All providers in Vineyard, UT · Pediatric Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.