Thomas Wild, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8103 Issued in TX

Practice address

6516 M D Anderson Blvd
Suite 352
Houston, TX 77030-3402

Phone

(713) 500-4141

Fax

(713) 500-4179

NPI assigned

Aug 20, 2007

Last updated

Aug 20, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1669665089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6516 M D ANDERSON BLVD",
            "address_2": "SUITE 352",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303402",
            "telephone_number": "713-500-4141",
            "fax_number": "713-500-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6516 M D ANDERSON BLVD",
            "address_2": "SUITE 352",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303402",
            "telephone_number": "713-500-4141",
            "fax_number": "713-500-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "8103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wild Rose Hospice, LLC. (Wild Rose Hospice)
• Wild Roses Therapy, PLLC.
• Wild Smiles Dental Center of Houston, PLLC
• Alexandra Wild, PA
• Lindsay Taylor Wild, OT
• Dianna Jane Wilde, DDS
• Lynn Wilde, COTA
• Mark C. Wilde, PSY.D.
• Angelica Marie Wilder
• Joseph Wilder, MD

• Pediatric Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.