Individual provider Active NPI

V Bruce Wilcox, DMD

  • General Practice Dentistry
  • Flagstaff, AZ
National Provider Identifier
1811086341
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D010487 Issued in AZ
Practice address
2920 N 4TH St
Flagstaff, AZ 86004-1816
Phone
(928) 522-9405
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 D010487 AZ Primary

Addresses

Primary practice location

2920 N 4TH St
Flagstaff, AZ 86004-1816

Mailing address

PO Box 17745
Munds Park, AZ 86017-7745
Phone (928) 522-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191024002556 AZ Practitioner - Dentist 4385938091 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. CurrentSince Aug 19, 2019 Accepting new patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Aug 19, 2019 Accepting new patients
Dr Mileski DDS PLLC General Practice PastSince Jun 7, 2020 Accepting new patients

Locations

2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100

1501 S Yale St
Ste 252
Flagstaff, AZ 86001
Phone (928) 774-1811

300 S 6th St
Williams, AZ 86046
Phone (928) 635-4441

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

Organizations & group practices 6

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1811086341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17745",
            "city": "MUNDS PARK",
            "state": "AZ",
            "postal_code": "860177745",
            "telephone_number": "928-522-9400",
            "fax_number": "928-774-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N 4TH ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041816",
            "telephone_number": "928-522-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "V",
        "middle_name": "BRUCE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.