NPIMap

Organization Active NPI

Wilson & Wilson, DDS PLLC

  • General Practice Dentistry
  • Centralia, WA
National Provider Identifier
1992087282
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00011026 Issued in WA
Legal business name
WILSON & WILSON, DDS PLLC
Practice address
1611 Kresky Ave Ste 118
Centralia, WA 98531-8982
Phone
(360) 736-1114
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Dr. Michelle B Wilson, DDSNPI 1104026483
Title
Owner
Phone
(360) 736-1114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00011026 WA Primary

Addresses

Primary practice location

1611 Kresky Ave Ste 118
Centralia, WA 98531-8982

Mailing address

1611 Kresky Ave Ste 118
Centralia, WA 98531-8982
Phone (360) 736-1114

Other names 1

  • Wilson & Wilson Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1611 Kresky Ave
Ste 118
Centralia, WA 98531
Phone (360) 736-1114

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1992087282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 KRESKY AVE STE 118",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318982",
            "telephone_number": "360-736-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 KRESKY AVE STE 118",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318982",
            "telephone_number": "360-736-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON & WILSON, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-736-1114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00011026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson & Wilson Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.