Individual provider Active NPI

Gregg W Wilson, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Indiana, PA
National Provider Identifier
1659337061
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS022854L Issued in PA
Practice address
841 Hospital Rd
Ste 2700
Indiana, PA 15701
Phone
(724) 349-6483
Fax
(724) 349-6565
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS022854L PA Primary

Addresses

Primary practice location

841 Hospital Rd
Ste 2700
Indiana, PA 15701

Mailing address

841 Hospital Rd
Ste 2700
Indiana, PA 15701
Phone (724) 349-6483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000841 PA Practitioner - Oral Surgery 6204862956 Practice locations: Indiana, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS022854LPAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659337061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 HOSPITAL RD",
            "address_2": "STE 2700",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "15701",
            "telephone_number": "724-349-6483",
            "fax_number": "724-349-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 HOSPITAL RD",
            "address_2": "STE 2700",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "15701",
            "telephone_number": "724-349-6483",
            "fax_number": "724-349-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GREGG",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS022854L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.