Rachael Anne Wilson

Primary specialty

DentistTaxonomy code 122300000X

License

D13547 Issued in MN

Practice address

4200 West Old Shakopee Rd
Suite 100
Bloomington, MN 55437

Phone

(952) 831-6126

NPI assigned

Apr 15, 2015

Last updated

Aug 16, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rachael Rath Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PDG,P.a.

  dba Park Dental

  • General Practice Dentistry
  • Bloomington, MN
  • NPI 1306912480
  NPD (past)

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1851788988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 12TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554072731",
            "telephone_number": "406-672-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WEST OLD SHAKOPEE RD",
            "address_2": "SUITE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55437",
            "telephone_number": "952-831-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RACHAEL",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "RATH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria Shepard Williams, PA-C, MPAS
• Whitney Williams
• Cali Eve Williamson
• Willing Compassion Care Assisted Living Inc
• Kasey Christine Willson, PA-C, MPH
• Shontel Wilson, FNP-BC
• Vanessa Wilson
• Terri C Wilton, OTR/L
• Karen Gallagher Winker, LICSW
• Mary Margaret Winnett, MD

• Dentist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.