Elizabeth M Wilson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DD 3170 Issued in NM

Practice address

530 N Telshor Blvd
Suite a
Las Cruces, NM 88011-8243

Phone

(575) 532-5861

NPI assigned

Jul 24, 2009

Sex

Female

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

• Elizabeth Holliday Former name

Medicare fee-for-service enrollment

Enrolled in NM

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Dental Services LLC

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1033899547
  NPD Authorized official

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1770713620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N TELSHOR BLVD",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118243",
            "telephone_number": "575-532-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N TELSHOR BLVD",
            "address_2": "SUITE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118243",
            "telephone_number": "575-532-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD 3170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HOLLIDAY",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dianne C Wilson McElyea, CNP
• Aaron Paul Wilson, R.PH.
• Adrienne Carol Wilson, LPCC
• Benjamin David Wilson, M.D.
• Elisha Jaedon Wilson
• Jeremiah B Wilson, MSW
• Joseph Wilson, D.C.
• Kaile Wilson
• Kerrin Noel Wilson, LISW
• Rosemary Wilson

• All providers in Las Cruces, NM
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.