Wilson Kingsley Allen, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10287 Issued in KY

Practice address

230 Connector Rd
Georgetown, KY 40324-9722

Phone

(502) 642-5008

NPI assigned

Jun 4, 2019

Sex

Male

Sole proprietor

No

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.

• Dustin Mayrand DMD PLLC

  • General Practice Dentistry
  • Georgetown, KY
  • NPI 1588410088
  NPD (past) GENERAL PRACTICE

Medicare fee-for-service enrollment

Enrolled in KY

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 4, 2019.

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1972161933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CONNECTOR RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249722",
            "telephone_number": "502-642-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 CONNECTOR RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249722",
            "telephone_number": "502-642-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "WILSON",
        "middle_name": "KINGSLEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Ira Allen, DMD
• Brian L Allen, M.D.
• Bridgette Kaye Allen, MFT
• Jackie M. Allen, MS, CCC-SLP
• Laura Anne Allen, MS, RD, LD
• Allison Henley, DMD, PLLC
• Antonio Allman
• Dalia Marie Alsous
• Shahad Alwan, DMD
• American Best Practices, LLC

• All providers in Georgetown, KY
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.