Active NPI
Haley Elise Wilson, DDS
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1609659671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 39545
- Practice address
- 3100 Monticello Ave Ste 110
Dallas, TX 75205-3441 - Phone
- (214) 380-9071
- NPI assigned
- Aug 15, 2023
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 39545 | TX | Primary |
Addresses
Primary practice location
3100 Monticello Ave Ste 110
Dallas, TX 75205-3441
Mailing address
4211 Rawlins St Unit 96
Dallas, TX 75219-2747
Phone (904) 885-1594
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 |
|---|---|---|---|
| 39545 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1609659671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 RAWLINS ST UNIT 96",
"city": "DALLAS",
"state": "TX",
"postal_code": "752192747",
"telephone_number": "904-885-1594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 MONTICELLO AVE STE 110",
"city": "DALLAS",
"state": "TX",
"postal_code": "752053441",
"telephone_number": "214-380-9071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "HALEY",
"middle_name": "ELISE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-15",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "39545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.