NPIMap

Organization Active NPI

Wilson Dentistry LLC

  • Dentist
  • Carmel, IN
National Provider Identifier
1922530823
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012331A Issued in IN
Legal business name
WILSON DENTISTRY LLC
Practice address
11711 N Pennsylvania St
Carmel, IN 46032-6959
Phone
(317) 816-0841
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Dr. Jody Wilson, DDS
Title
Dentist/Owner
Phone
(317) 551-8040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12012331A IN Primary

Addresses

Primary practice location

11711 N Pennsylvania St
Carmel, IN 46032-6959

Mailing address

11711 N Pennsylvania St
Carmel, IN 46032-6959
Phone (317) 816-0841

Other names 1

  • Image Dental Doing business as

National Provider Directory

National Provider Directory

Locations

11711 Pennsylvania St
Carmel, IN 46032
Phone (317) 816-0841

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1922530823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 N PENNSYLVANIA ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326959",
            "telephone_number": "317-816-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 N PENNSYLVANIA ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326959",
            "telephone_number": "317-816-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "317-551-8040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012331A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Image Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.