Individual provider Active NPI

Gregory Todd Wilkinson, DDS

  • Pediatric Dentistry
  • Memphis, TN
National Provider Identifier
1962597971
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS007065 Issued in TN
Practice address
5610 Murray Rd
Memphis, TN 38119
Phone
(901) 767-3390
Fax
(901) 763-0465
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS007065 TN
Pediatric Dentistry 1223P0221X DS007065 TN Primary

Addresses

Primary practice location

5610 Murray Rd
Memphis, TN 38119

Mailing address

5610 Murray Rd
Memphis, TN 38119
Phone (901) 767-3390

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
DS007065TNMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory T. Wilkinson DDS PC Pediatric Dentistry CurrentSince Dec 13, 2022 Accepting new patients

Locations

5610 Murray Ave
Memphis, TN 38119
Phone (901) 767-3390

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1962597971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 MURRAY RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-767-3390",
            "fax_number": "901-763-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 MURRAY RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-767-3390",
            "fax_number": "901-763-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "GREGORY",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS007065",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "DS007065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.