Marla Wilson DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

12009690 Issued in IN

Legal business name

MARLA WILSON DDS PC

Doing business as

Premier Dental Care

Practice address

6920 S East St
Suite a
Indianapolis, IN 46227-2215

Phone

(317) 787-6625

Fax

(317) 787-4945

NPI assigned

Jun 13, 2007

Last updated

Dec 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marla Kay Wilson, DDSNPI 1760645980

Title

Dentist

Phone

(317) 787-6625

Specialties & licenses 1

Addresses

Other names 1

• Premier Dental Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Marla K. Wilson, D.D.S.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1760645980
  Authorized official Same address or phone

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1770787657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 S EAST ST",
            "address_2": "SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272215",
            "telephone_number": "317-787-6625",
            "fax_number": "317-787-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6920 S EAST ST",
            "address_2": "SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272215",
            "telephone_number": "317-787-6625",
            "fax_number": "317-787-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLA WILSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARLA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "317-787-6625",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Marks Jr., DO
• Tonya Dawn Marks, EFDA
• Rosetta D Marksberry, CSFA
• Nathan Peter Markus, DO
• Wade Markus, PTA
• Phyllis T Marlar, MD
• Matthew Marley, MD
• Margarita Marlin, M.D.
• Keith Marlow
• Sean Marlow, RN

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.