Active NPI
David Lee Wilson, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Palmdale, CA
National Provider Identifier
1902892540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- D25778
- Practice address
- 41253 12TH St W
Suite C
Palmdale, CA 93551-1413 - Phone
- (661) 266-8840
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D25778 | CA | Primary |
Addresses
Primary practice location
41253 12TH St W
Suite C
Palmdale, CA 93551-1413
Mailing address
41253 12TH St W
Suite C
Palmdale, CA 93551-1413
Phone (661) 266-8840
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D25778 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1902892540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41253 12TH ST W",
"address_2": "SUITE C",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935511413",
"telephone_number": "661-266-8840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41253 12TH ST W",
"address_2": "SUITE C",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935511413",
"telephone_number": "661-266-8840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DAVID",
"middle_name": "LEE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "D25778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.