Blair Austin Willcox, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

AZD4391 Issued in AZ

Practice address

19555 N 59TH Ave - Cdmi
Glendale, AZ 85308

Phone

(480) 580-7222

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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)

Enrolled

State licenses

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1497843411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 N ALAMO CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852132265",
            "telephone_number": "480-580-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19555 N 59TH AVE - CDMI",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "480-580-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLCOX",
        "first_name": "BLAIR",
        "middle_name": "AUSTIN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "AZD4391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Wilkins
• Linda Zoe Wilkinson, L.A.C.
• Rebecca Lee Wilks, MD
• Anthony Michael Will, D.O.
• Mathew Willarch, BA, BHT
• William E. Zachow D.O., P.C.
• William H Castro MD PC
• William H. Frost,D.D.S., P.C.
• Courtney Williams, RN
• Daryl Williams

• Dentist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.