Randall E Wilson DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RANDALL E WILSON DDS

Practice address

4121 Old Collinsville Rd
Swansea, IL 62226-2511

Phone

(618) 236-0501

NPI assigned

May 5, 2020

Last updated

Jul 23, 2025By 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. Randall E Wilson, DDSNPI 1164540365

Title

Owner

Phone

(618) 236-0501

Specialties & licenses 2

Addresses

Locations

Practitioners 3

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.

• Randall Eugene Wilson, D.D.S.

  • General Practice Dentistry
  • Swansea, IL
  • NPI 1164540365
  NPD Authorized official
• Lauren Brittany Wilson, DMD

  • General Practice Dentistry
  • Swansea, IL
  • NPI 1730700477
  NPD
• Jeffrey Charles Banker, DDS MS

  • General Practice Dentistry
  • Swansea, IL
  • NPI 1467438374
  NPD (past)

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1891316535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 OLD COLLINSVILLE RD",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262511",
            "telephone_number": "618-236-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 OLD COLLINSVILLE RD",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262511",
            "telephone_number": "618-236-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL E WILSON DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-236-0501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Provider Plus LLC (AdaptHealth)
• Bonnie Przetacznik, OTR
• Thaer Adeeb Qasem
• Tara Nicole Quirin, PHARM.D
• Randall C Markarian DMD, Ms, PC
• Max Rava
• Reckoning Health Services PLLC
• Ina E Redstone, LMT
• Rehabcare Group East, LLC (RehabCare)
• Renner Chiropractic LLC

• Dental Clinic/Center in Swansea, IL
• Providers in Swansea, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.