Douglas C Wilson, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4818 Issued in WA

Practice address

4207 Tieton Drive
Yakima, WA 98908-3347

Phone

(509) 965-8911

Fax

(509) 965-6143

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811071483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 TIETON DRIVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083347",
            "telephone_number": "509-965-8911",
            "fax_number": "509-965-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 TIETON DRIVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083347",
            "telephone_number": "509-965-8911",
            "fax_number": "509-965-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DOUGLAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "4818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5504303",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charity L. Willis, LMP
• Willow Springs Care (Willow Springs Care and Rehabilitation)
• Willow Springs SNF Operations LLC (Apple Valley Health & Rehabilitation)
• Casey Wilsey, LMT
• Stephanie Wilske, LMP
• Jared Benjamin Wilson, DC
• Jessica Marie Wilson, LMP
• Joseph Robert Wilson, D.M.D
• Joshua Wilson
• Michael Britt Wilson, D.C.

• Oral and Maxillofacial Surgery (Dentist) in Yakima, WA
• Providers in Yakima, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.