Active NPI
John Hinton Wilson, DMD
- Periodontics
- Jacksonville, FL
National Provider Identifier
1780647388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN012047
- Practice address
- Bureau of Medicine and Surgery Detachment Jacksonville
Building 554
Jacksonville, FL 32212-0140 - Phone
- (877) 772-4373
- NPI assigned
- Apr 7, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12047 | GA | |
| Periodontics | 1223P0300X | DN012047 | GA | Primary |
Addresses
Primary practice location
Bureau of Medicine and Surgery Detachment Jacksonville
Building 554
Jacksonville, FL 32212-0140
Mailing address
Bureau of Medicine and Surgery Detachment Jacksonville
Building 554
Jacksonville, FL 32212-0140
Phone (877) 772-4373
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 |
|---|---|---|---|
| 12047 | GA | MD | Dentist |
| DN012047 | GA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1780647388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BUREAU OF MEDICINE AND SURGERY DETACHMENT JACKSONVILLE",
"address_2": "BUILDING 554",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322120140",
"telephone_number": "877-772-4373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BUREAU OF MEDICINE AND SURGERY DETACHMENT JACKSONVILLE",
"address_2": "BUILDING 554",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322120140",
"telephone_number": "877-772-4373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JOHN",
"middle_name": "HINTON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-07",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "12047",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "GA",
"license": "DN012047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.