Individual provider Active NPI

Arthur Edward Wilk Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Clinton, CT
National Provider Identifier
1528171675
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6499 Issued in CT
Practice address
34 West Main St
Clinton, CT 06413
Phone
(860) 669-3219
Fax
(860) 669-3258
NPI assigned
Aug 15, 2006
Last updated
Mar 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6499 CT Primary

Addresses

Primary practice location

34 West Main St
Clinton, CT 06413

Mailing address

34 West Main Street
Clinton, CT 06413
Phone (860) 669-3219

Other identifiers 1

IdentifierTypeStateIssuer
002064997MedicaidCT

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Raphael Faculty Physicians Oral and Maxillofacial Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: awilk4969@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1528171675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WEST MAIN STREET",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "06413",
            "telephone_number": "860-669-3219",
            "fax_number": "860-669-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WEST MAIN ST",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "06413",
            "telephone_number": "860-669-3219",
            "fax_number": "860-669-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILK",
        "first_name": "ARTHUR",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "6499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002064997",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.