Charles Brent Wilson DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6033 Issued in LA

Legal business name

CHARLES BRENT WILSON DDS LLC

Doing business as

St. Francisville Family Dentistry

Practice address

7689 US Hwy 61
Saint Francisville, LA 70775-0820

Phone

(225) 635-6554

Fax

(225) 635-6239

NPI assigned

Jun 17, 2010

Last updated

Jul 29, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Brent Wilson, DDSNPI 1629399522

Title

Owner

Phone

(225) 454-9680

Specialties & licenses 1

Addresses

Other names 1

• St. Francisville Family Dentistry Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Brent Wilson, D.D.S.

  • General Practice Dentistry
  • Saint Francisville, LA
  • NPI 1629399522
  NPD (past) Authorized official

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1962723502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "address_2": "7689 US HWY 61",
            "city": "SAINT FRANCISVILLE",
            "state": "LA",
            "postal_code": "707750474",
            "telephone_number": "225-635-6554",
            "fax_number": "225-635-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7689 US HWY 61",
            "city": "SAINT FRANCISVILLE",
            "state": "LA",
            "postal_code": "707750820",
            "telephone_number": "225-635-6554",
            "fax_number": "225-635-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES BRENT WILSON DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-454-9680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Francisville Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emmaleigh Brooke Bock, M.D.
• Grace Ellen Burns
• Erin Lofton Cain, M.A., SLP
• Capital Area Human Services District (West Feliciana Behavioral Health CCBHC)
• Capital Area Human Services District (West Feliciana Center for Addiction Recovery)
• Children's TL (Geaux Play Pediatric Therapy Services)
• Mark Chustz, LCSW
• Clear Path to Wellness
• Clifton G. Elliott, LLC (Elliott Pharmacy)
• Commute Safer Medi Trans LLC

• General Practice Dentistry in Saint Francisville, LA
• Providers in Saint Francisville, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.