Active NPI
Keshia Nichole Wilson
- Dental Assistant
- Cincinnati, OH
National Provider Identifier
1609347863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 51.026023
- Practice address
- 2030 Fairfax Ave
Cincinnati, OH 45207-1943 - Phone
- (513) 363-7790
- Fax
- (513) 363-7790
- NPI assigned
- Dec 16, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 51.026023 | KY | Primary |
Addresses
Primary practice location
2030 Fairfax Ave
Cincinnati, OH 45207-1943
Mailing address
3101 Burnet Avenue
Cincinnati, OH 45229
Phone (513) 357-7383
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 |
|---|---|---|---|
| 51.026023 | KY | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544918400000",
"number": "1609347863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 BURNET AVENUE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45229",
"telephone_number": "513-357-7383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 FAIRFAX AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452071943",
"telephone_number": "513-363-7790",
"fax_number": "513-363-7790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KESHIA",
"middle_name": "NICHOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-16",
"last_updated": "2018-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "KY",
"license": "51.026023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.