NPIMap

Organization Active NPI

Edwards & Wilson Periodontics, PA

  • Periodontics
  • Lawrence, KS
National Provider Identifier
1699884965
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6357 Issued in KS
Legal business name
EDWARDS & WILSON PERIODONTICS, PA
Practice address
4830 Quail Crest Place
Lawrence, KS 66049-3838
Phone
(785) 843-4076
Fax
(785) 843-6127
NPI assigned
Aug 30, 2006
Last updated
Jan 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Authorized official

Name
Mrs. Ashli E Gill
Title
Billing Manager
Phone
(785) 843-4076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 6357 KS Primary

Addresses

Primary practice location

4830 Quail Crest Place
Lawrence, KS 66049-3838

Mailing address

4830 Quail Crest Place
Lawrence, KS 66049-3838
Phone (785) 843-4076

Other identifiers 2

IdentifierTypeStateIssuer
1672853562OtherKSNPI FOR DENTIST ADDED TO OUR PRACTICE
61063OtherKSDENTIST LICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Edwards Wilson Periodontics PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1699884965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 QUAIL CREST PLACE",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660493838",
            "telephone_number": "785-843-4076",
            "fax_number": "785-843-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 QUAIL CREST PLACE",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660493838",
            "telephone_number": "785-843-4076",
            "fax_number": "785-843-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDS & WILSON PERIODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "ASHLI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "785-843-4076",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KS",
            "license": "6357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DENTIST ADDED TO OUR PRACTICE",
            "identifier": "1672853562",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST LICENSE NUMBER",
            "identifier": "61063",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; 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.