WILSON DENTAL PLLC (NPI# 1265935902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265935902 |
| Entity Type | Organization |
| Organization Name | WILSON DENTAL PLLC |
| Practice Address |
10497 W Garverdale Ct Ste 107 Boise ID 83704-5468 |
| Practice Telephone | 2083755720 |
| Practice Fax Number | 2083238538 |
| Mailing Telephone | 2083755720 |
| Mailing Fax Number | 2083238538 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-08 |
| Authorized Official Name | DR. GREGG ANDREW WILSON (DENTIST/CEO) |
| Authorized Official Telephone | 2089060501 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D35345 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807297400 | 05 |
| Street Address |
10497 W GARVERDALE CT STE 107 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-5468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831678903 | Town Square Dental Partners, Pllc | Clinic/Center | 8660 W Emerald St Ste 152, Boise, ID 83704-4828 | 2018-08-09 |
| 1912356841 | Joseph P. Schmidt Pllc | Clinic/Center | 2600 W Rose Hill St, Suite 100, Boise, ID 83705-5967 | 2016-06-10 |
| 1487046363 | Boise Caring Dentistry, P.C. | Clinic/Center | 5630 N Eagle Rd, Suite 101, Boise, ID 83713-4901 | 2015-03-02 |
| 1598154981 | Horizon 1 Pllc | Clinic/Center | 1000 N Curtis Rd Ste 103, Boise, ID 83706-1345 | 2015-01-22 |
| 1336220144 | Robert O Stevens Dmd, Pa | Clinic/Center | 10572 W Business Park Ln, Boise, ID 83709-6797 | 2006-10-18 |
| 1902810633 | Community Health Clinics | Clinic/Center | 2301 N 36th St, Suite 102, Boise, ID 83703-5207 | 2006-07-28 |
| 1255339297 | Dr. Kaci B. Jensen, Pllc | Clinic/Center | 9755 W Leo Dr, Boise, ID 83709-8249 | 2005-07-13 |
| 1427669720 | Lake Harbor Dental Pllc | Clinic/Center | 5355 W State St, Boise, ID 83703-3333 | 2020-08-11 |
| 1659915437 | Weimer Dental Pllc | Clinic/Center | 8336 W Northview St, Boise, ID 83704-7132 | 2019-11-04 |
| 1497317788 | Hidden Springs Dental | Clinic/Center | 5833 W Hidden Springs Dr, Boise, ID 83714-9453 | 2019-07-08 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.