Dominque Wilson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704360018 Issued in MI

Practice address

25639 Ford Rd
Dearborn Heights, MI 48127-4817

Phone

(313) 277-3293

Fax

(313) 277-0917

NPI assigned

Sep 24, 2025

Last updated

Sep 25, 2025By the provider in NPPES

Sex

Female

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": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1700759966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "602-248-8886",
            "fax_number": "602-248-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25639 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274817",
            "telephone_number": "313-277-3293",
            "fax_number": "313-277-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DOMINQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704360018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chevalla Les White, CNA/DCW
• Tamaria Marimba White, RN
• Tanganyika Wilkerson
• Charlotte Nicole Williams, DPT
• Regina Williams
• Magnus A Wilson, DDS
• Christine Marie Winfree, BS, MOT, OTR
• WM Home Care & Cleaning LLC
• Womens Health Associates PLLC
• Woodward Detroit CVS LLC (CVS Pharmacy #16132)

• Registered Nurse in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.