Greggory S Wilde III, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Practice address

3594 NW Lowell St
Silverdale, WA 98383-9116

Phone

(360) 692-0300

Fax

(360) 698-2998

NPI assigned

May 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greggory S. Wilde, DDS, PS

  • Periodontics
  • Silverdale, WA
  • NPI 1497845523
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952514689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6731 KITSAP WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121739",
            "telephone_number": "360-373-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3594 NW LOWELL ST",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839116",
            "telephone_number": "360-692-0300",
            "fax_number": "360-698-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "GREGGORY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traci Whyte
• Brian P Wicks, M.D.
• George Edward Wiggins, M.D.
• Amie Charie Wilcox, APRN
• Peter G. Wilcox, ARNP
• Faith M Wilder, CBT
• Willamette Dental Group, P.C.
• Cynthia S Willard, LMP, CNB, PTA
• Jon M Willems, OD
• Danielle Lee Williams

• Periodontics in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Periodontics in Washington

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.