Charles Lawrence Wilson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16812 Issued in OH

Practice address

5231 Mayfield Rd
Lyndhurst, OH 44124-2407

Phone

(440) 442-5990

Fax

(440) 442-9114

NPI assigned

Feb 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659412633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5231 MAYFIELD RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242407",
            "telephone_number": "440-442-5990",
            "fax_number": "440-442-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5231 MAYFIELD RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242407",
            "telephone_number": "440-442-5990",
            "fax_number": "440-442-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "16812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Whipple, LCSW, ACSW
• Cherie Ann White, M.ED. PCC-S
• Janet S Wieselthier, M.D.
• William F. Lavigna DDS Inc
• Catherine Williams
• Miah Davis Wilson, PA-C
• Carly Rose Wohlfeiler, AUD
• Amy Wolf, RD, LD
• Rina Wolovitz
• Toimeicka La June Worthy, CNP

• General Practice Dentistry in Lyndhurst, OH
• Providers in Lyndhurst, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.