David G Wilson III, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN4921 Issued in FL

Practice address

3440 Conway Blvd
Suite # 1-B
Port Charlotte, FL 33952-7000

Phone

(941) 625-5141

Fax

(941) 625-5001

NPI assigned

Feb 7, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. David G Wilson III Professional name

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": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1881872257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 CONWAY BLVD",
            "address_2": "SUITE # 1-B",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527000",
            "telephone_number": "941-625-5141",
            "fax_number": "941-625-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 CONWAY BLVD",
            "address_2": "SUITE # 1-B",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527000",
            "telephone_number": "941-625-5141",
            "fax_number": "941-625-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN4921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "WILSON",
            "middle_name": "G",
            "prefix": "DR.",
            "suffix": "III",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Samiya M Williams, RCSWI
• Stacey H Williams, PTA
• Susan Forster Williams, M.D.
• Veronica Williams, LMHC
• Carol Wilson, APRN
• Jennifer Lee Wilson
• Kathryn M. Wilson
• Scott Wilson, ARNP
• Daisy Nichole Wiman, ITDS
• Winding Road Emergency Physicians, LLC

• Dentist in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.