Charlyn A Wilson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS7079 Issued in TN

Practice address

7685 Wolf River Cir
Suite 102
Germantown, TN 38138-1749

Phone

(901) 751-1100

Fax

(901) 751-1164

NPI assigned

Feb 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Locations

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.

• St Jude Children'S Research Hospital, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1306335088
  Medicare reassignment NPD
• Charlyn Wilson DDS PLLC

  • Dentist
  • Germantown, TN
  • NPI 1558819607
  NPD Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972638922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7685 WOLF RIVER CIR",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381749",
            "telephone_number": "901-751-1100",
            "fax_number": "901-751-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7685 WOLF RIVER CIR",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381749",
            "telephone_number": "901-751-1100",
            "fax_number": "901-751-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLYN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS7079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4132991",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jena Parker Willis, NP-C
• Michael D Wilons, M.D.
• Amy Katherine Wilson
• Arthur James Wilson, M.D.
• Charkecia Wilson
• Whitney Claire Howarth Wilson, M.S., CCC-SLP
• Ann Wine, SLP
• Yolanda M Winfrey, NP
• Leah Wingfield
• Gabor A. Winkler, MD

• General Practice Dentistry in Germantown, TN
• Providers in Germantown, TN by specialty
• General Practice Dentistry in Tennessee

• 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.
• 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.