Joseph A. Wilson, DMD, MSD, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DD3399 Issued in NM

Practice address

4760 N Butler Ave
Suite a
Farmington, NM 87401-0816

Phone

(702) 469-3590

Fax

(702) 469-3590

NPI assigned

Nov 15, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1548561038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVE",
            "address_2": "SUITE A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010816",
            "telephone_number": "702-469-3590",
            "fax_number": "702-469-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVE",
            "address_2": "SUITE A",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010816",
            "telephone_number": "702-469-3590",
            "fax_number": "702-469-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOSEPH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD, LLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3399",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "49293029922",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NM",
            "license": "DD3399",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "49293029922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genevieve Willis, FNP-C
• Janet M Wilmes, M.D.
• Anne Jeannette Wilson
• Christianna Wilson
• Jens Wilson, DMD
• Mary Louise Wilson, SLP, M.S.-CCC
• Stephanie Ann Wilson
• Madison Paris Wimbish, CPSW, CCSS, LSAA
• James B Winblad, M.D.
• Kenneth P. Wingrove, D.C.

• Orthodontics and Dentofacial Orthopedics Dentistry in Farmington, NM
• Providers in Farmington, NM by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.