Tracy L. Wilkerson, DDS, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3529 Issued in WV

Legal business name

TRACY L. WILKERSON, DDS, PLLC

Doing business as

Children's Dentistry

Practice address

1400 Kanawha Blvd E
Charleston, WV 25301-3002

Phone

(304) 345-0541

Fax

(304) 345-8718

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tracy Lynn Wilkerson, DDSNPI 1528024460

Title

Pediatric Specialist

Phone

(304) 345-0541

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Children's Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Lynn Wilkerson, DDS

  • Pediatric Dentistry
  • Charleston, WV
  • NPI 1528024460
  NPD (past) Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760501001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 KANAWHA BLVD E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013002",
            "telephone_number": "304-345-0541",
            "fax_number": "304-345-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 KANAWHA BLVD E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013002",
            "telephone_number": "304-345-0541",
            "fax_number": "304-345-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY L. WILKERSON, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PEDIATRIC SPECIALIST",
        "authorized_official_telephone_number": "304-345-0541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WV",
            "license": "3529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1528024460",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4005111000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005586",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Townhill
• Casey Jo Townsend, MOT
• Jenna Daniele Townsend, PA-C
• Eva Townson
• Mackenzie Townson
• Crystal Tracy
• Tara Tracy
• Ameisha Trammell
• S Willis Trammell, M.D.
• Transport Housing LLC

• Pediatric Dentistry in Charleston, WV
• Providers in Charleston, WV by specialty
• Pediatric Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.