Active NPI
J Whitley Wills, DDS
- Dentist
- Memphis, TN
National Provider Identifier
1508986860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS005141
- Practice address
- 59 South Idlewild Street
Memphis, TN 38104 - Phone
- (901) 726-9525
- Fax
- (901) 726-9562
- NPI assigned
- Mar 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS005141 | TN | Primary |
Addresses
Primary practice location
59 South Idlewild Street
Memphis, TN 38104
Mailing address
59 South Idlewild Street
Memphis, TN 38104
Phone (901) 726-9525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS005141 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508986860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59 SOUTH IDLEWILD STREET",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38104",
"telephone_number": "901-726-9525",
"fax_number": "901-726-9562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 SOUTH IDLEWILD STREET",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38104",
"telephone_number": "901-726-9525",
"fax_number": "901-726-9562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLS",
"first_name": "J",
"middle_name": "WHITLEY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "DS005141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.