Active NPI
Leigh Hartman Wilson, D.M.D.
- Pediatric Dentistry
- Gastonia, NC
National Provider Identifier
1952754970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 10466
- Practice address
- 890 Summit Crossing PL
Gastonia, NC 28054-2192 - Phone
- (704) 874-0377
- Fax
- (704) 853-5455
- NPI assigned
- Jul 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 10466 | NC | Primary |
| Pediatric Dentistry | 1223P0221X | 9119 | SC |
Addresses
Primary practice location
890 Summit Crossing PL
Gastonia, NC 28054-2192
Mailing address
200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1936
Other practice location 1
2349 Cherry Rd Ste 49
Rock Hill, SC 29732-2132
Phone (803) 619-0090
Other practice location 2
221 Simpson Park Rd
Shelby, NC 28150-4299
Phone (704) 484-3366
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 |
|---|---|---|---|
| 10466 | NC | MD | Pharmacist |
| 9119 | SC | MD | Orthopedic Physical Therapist |
Interoperability endpoints
- lwilson2798466@carolinashealthcaresystem.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1952754970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E 2ND AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524358",
"telephone_number": "704-874-1936",
"fax_number": "704-865-4614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "890 SUMMIT CROSSING PL",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542192",
"telephone_number": "704-874-0377",
"fax_number": "704-853-5455"
}
],
"practiceLocations": [
{
"address_1": "2349 Cherry Rd Ste 49",
"address_purpose": "LOCATION",
"city": "Rock Hill",
"state": "SC",
"postal_code": "297322132",
"country_code": "US",
"telephone_number": "803-619-0090",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "221 Simpson Park Rd",
"address_purpose": "LOCATION",
"city": "Shelby",
"state": "NC",
"postal_code": "281504299",
"country_code": "US",
"telephone_number": "704-484-3366",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "LEIGH",
"middle_name": "HARTMAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-14",
"last_updated": "2023-03-03",
"certification_date": "2023-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "10466",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "SC",
"license": "9119",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.