Individual provider Active NPI

Catherine Grace Wilcox, DDS

  • General Practice Dentistry
  • Battle Creek, MI
National Provider Identifier
1790738557
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017210 Issued in MI
Practice address
395 S Shore Dr Ste 102
Battle Creek, MI 49014-5466
Phone
(269) 963-7861
Fax
(269) 963-0579
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901017210 MI Primary

Addresses

Primary practice location

395 S Shore Dr Ste 102
Battle Creek, MI 49014-5466

Mailing address

395 S Shore Dr Ste 102
Battle Creek, MI 49014-5466
Phone (269) 963-7851

Other identifiers 1

IdentifierTypeStateIssuer
3367672MedicaidMI

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

LicenseStateTypeSpecialty
2901017210MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Catherine G. Wilcox DDS LLC CurrentSince Sep 25, 2022 Accepting new patients
Catherine G. Wilcox, DDS Past Accepting new patients

Locations

395 S Shore Dr
Ste 102
Battle Creek, MI 49014
Phone (269) 963-7861

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1790738557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 S SHORE DR STE 102",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145466",
            "telephone_number": "269-963-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 S SHORE DR STE 102",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145466",
            "telephone_number": "269-963-7861",
            "fax_number": "269-963-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "CATHERINE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3367672",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.