Bradley Paul Wilson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61195 Issued in CA

Practice address

530 Lomas Santa Fe Dr Ste 2
Solana Beach, CA 92075-1350

Phone

(858) 794-9994

NPI assigned

Jun 20, 2011

Last updated

Jan 10, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1699061598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 BROOKSIDE CT",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920113263",
            "telephone_number": "858-220-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 LOMAS SANTA FE DR STE 2",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920751350",
            "telephone_number": "858-794-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRADLEY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Terry Wepsic, D.D.S.
• Michael White, DACM
• Dennel R Wildey, NP
• Stephanie Williams, DPT
• Stephanie C Williams, PA-C
• Morgan Wolf, DNP, FNP, AGNP
• Qiu Xie, M.S
• Heather Renee Yaryan, DNP, PMHNP-BC
• Amy Yates, PT
• Yoon Ophthalmology, PC

• General Practice Dentistry in Solana Beach, CA
• Providers in Solana Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.