Individual provider Active NPI

Wilner Loiseau

  • Periodontics
  • Richardson, TX
National Provider Identifier
1942369418
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22356 Issued in TX
Practice address
1750 Alma Rd
Suite 108
Richardson, TX 75081-6725
Phone
(972) 720-9373
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

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
Periodontics 1223P0300X 22356 TX Primary

Addresses

Primary practice location

1750 Alma Rd
Suite 108
Richardson, TX 75081-6725

Mailing address

650 International Pkwy
Suite 100
Richardson, TX 75081-6612
Phone (972) 720-9373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160328000026 TX Order and Referring Only - DentistPractitioner - Dentist 8820302318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22356TXMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942369418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 INTERNATIONAL PKWY",
            "address_2": "SUITE 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750816612",
            "telephone_number": "972-720-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 ALMA RD",
            "address_2": "SUITE 108",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750816725",
            "telephone_number": "972-720-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOISEAU",
        "first_name": "WILNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "22356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.