Southview Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

8162 Issued in NC

Legal business name

SOUTHVIEW DENTISTRY

Practice address

2201 South Blvd
Suite 210
Charlotte, NC 28203-6204

Phone

(704) 333-4760

NPI assigned

Aug 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Micheal Scott Wilson, DDS

Title

Dentist/Owner

Phone

(704) 333-4760

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• South End Dentistry Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Brooks Wilson, DDS

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1841330768
  NPD (past)

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270166400000",
    "number": "1962634816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 SOUTH BLVD",
            "address_2": "SUITE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036204",
            "telephone_number": "704-333-4760",
            "fax_number": "704-333-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 SOUTH BLVD",
            "address_2": "SUITE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036204",
            "telephone_number": "704-333-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHVIEW DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2010-04-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "704-333-4760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "8162",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8162",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841330768",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568522183",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South End Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Southpark Pediatrics, P.a.
• Southpark Psychotherapy PLLC
• Southpark Senior Living LLC
• Southpark Surgery Center LLC
• Southside Counseling Center, LLC
• Anna Southwick, LCMHCS
• Paige Southwick
• Kayla M Sova
• Austin Sowell
• Jamyaih Shunele Marie Sowell

• Dentist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2010; 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.