Active NPI
Lauren Kirsten Wilson, DDS
- General Practice Dentistry
- Park City, KS
National Provider Identifier
1780424432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 62123
- Practice address
- 410 E 61St St N
Park City, KS 67219-1906 - Phone
- (316) 744-0001
- NPI assigned
- May 30, 2024
- Last updated
- May 30, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 62123 | KS | Primary |
Addresses
Primary practice location
410 E 61St St N
Park City, KS 67219-1906
Mailing address
410 E 61St St N
Park City, KS 67219-1906
Phone (316) 744-0001
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 |
|---|---|---|---|
| 62123 | KS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1780424432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 E 61ST ST N",
"city": "PARK CITY",
"state": "KS",
"postal_code": "672191906",
"telephone_number": "316-744-0001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 E 61ST ST N",
"city": "PARK CITY",
"state": "KS",
"postal_code": "672191906",
"telephone_number": "316-744-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LAUREN",
"middle_name": "KIRSTEN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-30",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KS",
"license": "62123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.