John Chesley Wilson, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8985 Issued in KY

Practice address

2325 Green Valley Rd
Suite 1
New Albany, IN 47150-4600

Phone

(812) 944-9300

Fax

(812) 948-0547

NPI assigned

Aug 26, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

State licenses

Practice roles

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.

• Kids Dentistry-New Albany

  • Dental Clinic/Center
  • New Albany, IN
  • NPI 1366620247
  NPD (past)

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1962635870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 GREEN VALLEY RD",
            "address_2": "SUITE 1",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504600",
            "telephone_number": "812-944-9300",
            "fax_number": "812-948-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 GREEN VALLEY RD",
            "address_2": "SUITE 1",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504600",
            "telephone_number": "812-944-9300",
            "fax_number": "812-948-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOHN",
        "middle_name": "CHESLEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8813",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "8985",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12011910A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Elizabeth Willoughby, MSW, LSW
• Cameron Lebron Wilson
• Creagh Page Wilson, M.ED.
• Jamie Lynn Wilson, APRN
• Janice Marie Wilson, DMD RN
• Sarah H. Wilson, PA-C
• Steven M. Wilson, O.D.
• Angela Renee Winchester, MS, CCC-SLP
• Sara Winkler
• Ann B Winnecke, L.C.S.W.

• Pediatric Dentistry in New Albany, IN
• Providers in New Albany, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.