Active NPI
Kevin Drew Wilson, DMD
- General Practice Dentistry
- Milford, NH
National Provider Identifier
1649293531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3008
- Practice address
- 154 Elm St
Milford, NH 03055-4759 - Phone
- (603) 673-3332
- Fax
- (603) 672-5844
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- 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 | 3008 | NH | Primary |
Addresses
Primary practice location
154 Elm St
Milford, NH 03055-4759
Mailing address
154 Elm St
Milford, NH 03055-4759
Phone (603) 673-3332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30300251 | Medicaid | NH |
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 |
|---|---|---|---|
| 3008 | NH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dental Care of Milford, Prof. Assn. | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Milford, NH
- NPI 1356411839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1649293531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 ELM ST",
"city": "MILFORD",
"state": "NH",
"postal_code": "030554759",
"telephone_number": "603-673-3332",
"fax_number": "603-672-5844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 ELM ST",
"city": "MILFORD",
"state": "NH",
"postal_code": "030554759",
"telephone_number": "603-673-3332",
"fax_number": "603-672-5844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KEVIN",
"middle_name": "DREW",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NH",
"license": "3008",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30300251",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.