NPIMap

Individual provider Active NPI

Neal Kirkman Wilsted, DDS

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1912910902
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4097 Issued in CO
Practice address
7920 S University Blvd
Suite 200
Centennial, CO 80122-5103
Phone
(720) 489-0797
Fax
(720) 489-0934
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4097 CO Primary

Addresses

Primary practice location

7920 S University Blvd
Suite 200
Centennial, CO 80122-5103

Mailing address

7920 S University Blvd
Suite 200
Centennial, CO 80122-5103
Phone (720) 489-0797

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

LicenseStateTypeSpecialty
4097COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dan Rodda, DDS, PLLC Past Accepting new patients
Scott Lindsay DMD PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912910902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 S UNIVERSITY BLVD",
            "address_2": "SUITE 200",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801225103",
            "telephone_number": "720-489-0797",
            "fax_number": "720-489-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 S UNIVERSITY BLVD",
            "address_2": "SUITE 200",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801225103",
            "telephone_number": "720-489-0797",
            "fax_number": "720-489-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSTED",
        "first_name": "NEAL",
        "middle_name": "KIRKMAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "4097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.