Michelle D Wilkerson, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

1855276 Issued in MA

Practice address

17 Young St
Worcester, MA 01603-1420

Phone

(508) 753-6777

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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 and National Provider Directory roles.

• Webster Square Dental

  • General Practice Dentistry
  • Worcester, MA
  • NPI 1629116355
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1871652354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 BOYLSTON ST APT 5J",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021997905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 YOUNG ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031420",
            "telephone_number": "508-753-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "MICHELLE",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "1855276",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "7194",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902HM",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "902HM",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Ann Wilga
• Chelsea Elizabeth Wilk
• Karen Wilk, NP
• Stephen J Wilk II
• Ari Jacob Wilkenfeld, MD, PHD
• Frayah June Wilkey
• Gianna Wilkie, M.D.
• Alexander Wilkins, PHD
• Curtis P Wilkins, LICSW
• Brittany Wilkinson

• Pediatric Dentistry in Worcester, MA
• Providers in Worcester, MA by specialty
• Pediatric Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.