Leonard B Wilson DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEONARD B WILSON DMD PC

Practice address

1333 W Harvard Ave
Roseburg, OR 97471-2838

Phone

(541) 672-2747

Fax

(866) 216-6527

NPI assigned

Jul 1, 2015

Last updated

Jul 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leonard Bever Wilson, DMDNPI 1639550239

Title

Owner

Phone

(541) 672-2747

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leonard Wilson, D.M.D.

  • General Practice Dentistry
  • Roseburg, OR
  • NPI 1639550239
  Authorized official Same address or phone

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1881077329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712838",
            "telephone_number": "541-672-2747",
            "fax_number": "866-216-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712838",
            "telephone_number": "541-672-2747",
            "fax_number": "866-216-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD B WILSON DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "BEVER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-672-2747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Gene Leech, O.D.
• Melissa Leichner
• Ashley A Leisner-Pacini
• Julie Anne Leister, PMHNP
• Shawn Levi Lemert, D.D.S.
• Erin Leonard-Durrant
• Timothy James Leonard
• Netta Julie Leong, P.T.
• Kelsey Danielle Leroy Gomez
• Abigail M Levere, MSW

• General Practice Dentistry in Roseburg, OR
• Providers in Roseburg, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.