Active NPI
Timothy G Wilson, D.D.S.
- General Practice Dentistry
- Tucson, AZ
National Provider Identifier
1689701799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3909
- Practice address
- 1751 W Orange Grove Rd
BLDG 2
Tucson, AZ 85704-1194 - Phone
- (520) 797-8030
- Fax
- (520) 797-9369
- NPI assigned
- Feb 27, 2007
- 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 | 3909 | AZ | Primary |
Addresses
Primary practice location
1751 W Orange Grove Rd
BLDG 2
Tucson, AZ 85704-1194
Mailing address
1751 W Orange Grove Rd
BLDG 2
Tucson, AZ 85704-1194
Phone (520) 797-8030
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 |
|---|---|---|---|
| 3909 | AZ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sean Ham DDS, LLC | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689701799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1751 W ORANGE GROVE RD",
"address_2": "BLDG 2",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857041194",
"telephone_number": "520-797-8030",
"fax_number": "520-797-9369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1751 W ORANGE GROVE RD",
"address_2": "BLDG 2",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857041194",
"telephone_number": "520-797-8030",
"fax_number": "520-797-9369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TIMOTHY",
"middle_name": "G",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "3909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.