Active NPI
James Kenneth Wilson, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Chapel Hill, NC
National Provider Identifier
1700957354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 4157
- Practice address
- 121 S Estes Drive
Suite 205C
Chapel Hill, NC 27516 - Phone
- (919) 928-0105
- Fax
- (919) 928-0630
- NPI assigned
- Nov 13, 2006
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 4157 | NC | Primary |
Addresses
Primary practice location
121 S Estes Drive
Suite 205C
Chapel Hill, NC 27516
Mailing address
10404 Manly
Chapel Hill, NC 27517
Phone (919) 933-1646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7999405 | Medicaid | NC |
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 |
|---|---|---|---|
| 4157 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700957354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10404 MANLY",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "27517",
"telephone_number": "919-933-1646",
"fax_number": "919-933-3739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 S ESTES DRIVE",
"address_2": "SUITE 205C",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "27516",
"telephone_number": "919-928-0105",
"fax_number": "919-928-0630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JAMES",
"middle_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NC",
"license": "4157",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7999405",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
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.