Active NPI
Kyle A. Wilson, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- McKinney, TX
National Provider Identifier
1538396999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DE 60514923
- Practice address
- 3575 Lakota TRL Ste 200
McKinney, TX 75070-3601 - Phone
- (469) 907-1080
- Fax
- (972) 542-6691
- NPI assigned
- Jun 12, 2009
- Last updated
- Oct 3, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2009013997 | MO | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DE 60514923 | WA | Primary |
Addresses
Primary practice location
3575 Lakota TRL Ste 200
McKinney, TX 75070-3601
Mailing address
3575 Lakota TRL Ste 200
McKinney, TX 75070-3601
Phone (469) 907-1080
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009013997 | MO | MD | Dentist |
| DE 60514923 | WA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538524800000",
"number": "1538396999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3575 LAKOTA TRL STE 200",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750703601",
"telephone_number": "469-907-1080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3575 LAKOTA TRL STE 200",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750703601",
"telephone_number": "469-907-1080",
"fax_number": "972-542-6691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KYLE",
"middle_name": "A.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-12",
"last_updated": "2018-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2009013997",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WA",
"license": "DE 60514923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.