Magnus A Wilson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901011649 Issued in MI

Practice address

27281 W Warren St
Dearborn Heights, MI 48127-1804

Phone

(313) 274-4040

Fax

(313) 274-8080

NPI assigned

Jul 27, 2006

Last updated

Jul 8, 2007By 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

Other names 1

• Cambridge Dental Group Professional name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699799031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27281 W WARREN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271804",
            "telephone_number": "313-274-4040",
            "fax_number": "313-274-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27281 W WARREN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271804",
            "telephone_number": "313-274-4040",
            "fax_number": "313-274-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MAGNUS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901011649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMBRIDGE",
            "last_name": "GROUP",
            "middle_name": "DENTAL",
            "credential": "PPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tamaria Marimba White, RN
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• Regina Williams
• Dominque Wilson
• Christine Marie Winfree, BS, MOT, OTR
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• Dentist in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Dentist in Michigan

• 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.