Individual provider Active NPI

Scott Robert Wilcox, DDS

  • Dentist
  • Sauk Rapids, MN
National Provider Identifier
1972528628
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
07720 Issued in MN
Practice address
1139 Franklin Ave
Sauk Rapids, MN 56379-1230
Phone
(320) 253-4242
Fax
(320) 253-7778
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 07720 MN Primary

Addresses

Primary practice location

1139 Franklin Ave
Sauk Rapids, MN 56379-1230

Mailing address

1139 Franklin Ave
Sauk Rapids, MN 56379-1230
Phone (320) 253-4242

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
07720MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972528628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 FRANKLIN AVE",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791230",
            "telephone_number": "320-253-4242",
            "fax_number": "320-253-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 FRANKLIN AVE",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791230",
            "telephone_number": "320-253-4242",
            "fax_number": "320-253-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "07720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.