Marcus Allen Wilkerson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DEN4256 Issued in ME

Practice address

1048 Union St
Bangor, ME 04401-3016

Phone

(207) 992-2152

Fax

(207) 992-2154

NPI assigned

Jun 2, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1972739274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013016",
            "telephone_number": "207-992-2152",
            "fax_number": "207-992-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "MARCUS",
        "middle_name": "ALLEN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2009013195",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN4256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DEN4256",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tori-Lynn Wilcox, LCSW
• Chrysalis Wild
• Finn Wilder, FNP-BC
• Wildworks Therapy, PLLC
• Laura D. Wiley, LCSW
• Delany B Wilkes, DPT
• Janet R Wilks, SLP
• Celia Willard, MD
• Linda Willard, FNP
• Robin Willard, MD

• Dentist in Bangor, ME
• Providers in Bangor, ME by specialty
• Dentist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.