DR. MICHAEL JEREMY WILSON (NPI# 1386864528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386864528 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JEREMY WILSON |
| Credential | DDS PA |
| Practice Address |
2900 Croasdaile Dr Suite 3 Durham NC 27705-2579 |
| Practice Telephone | 9193837423 |
| Practice Fax Number | 9193833444 |
| Mailing Telephone | 9193837423 |
| Mailing Fax Number | 9193833444 |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
7088 | NC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203537 | Michael John Wilson | Clinical Neuropsychologist | 9301 Madison St Rm 369, Crown Point, IN 46307-7745 | 2019-06-11 |
| 1982268017 | Michael Donavan Wilson | Counselor | 200 North Lewis, Waukegan, IL 60087 | 2019-04-24 |
| 1891201604 | Michael Paul Wilson | Technician/Technologist | 324 Garden Rd, Springfield, PA 19064-3505 | 2017-12-18 |
| 1659897536 | Michael Wilson | Driver | 1628 Bucktown Dr, Danville, VA 24543 | 2017-08-22 |
| 1386096501 | Michael Wilson | Home Health | 596 North Hawkins Ave, Akron, OH 44313 | 2016-07-12 |
| 1164895728 | Michael Wilson | Counselor | 3027 Pleasant Grv, Bossier City, LA 71111-5758 | 2015-11-04 |
| 1013384379 | Michael Wilson | Counselor | 7110 Sw Fir Loop Ste 220, Tigard, OR 97223 | 2015-08-21 |
| 1467828350 | Michael Wilson | Social Worker | 30500 Southfield Road Apt. 200, Michael Wilson, Southfield, MI 48076 | 2015-08-14 |
| 1356723803 | Michael Wilson II | Home Health Aide | 348 Wilson Ave, Port Clinton, OH 43452-1740 | 2015-06-22 |
| 1467641399 | Michael C. Wilson | Developmental Therapist | 820 E 38th Pl Unit 1, Chicago, IL 60653-1969 | 2007-10-16 |
| Street Address |
2900 CROASDAILE DR SUITE 3 |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-2579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003805565 | Bruce Alan Pate | Optometrist | 2900 Croasdaile Dr, Ste. 6, Durham, NC 27705-2579 | 2005-10-18 |
| 1770966590 | Samantha Robles | Dentist | 2900 Croasdaile Dr, Suite 1, Durham, NC 27705-2579 | 2015-06-30 |
| 1790930790 | Jason Winfield Butler | Dentist | 2900 Croasdaile Dr, Suite #5, Durham, NC 27705-2579 | 2008-11-19 |
| 1275701336 | Wilson Orthodontics | Dentist | 2900 Croasdaile Dr, Suite 3, Durham, NC 27705-2579 | 2008-02-12 |
| 1609068212 | Optometric Center, P.a. | Clinic/Center | 2900 Croasdaile Dr, Durham, NC 27705-2579 | 2007-08-16 |
| 1427121342 | Kenneth L Walker | Dentist | 2900 Croasdaile Dr, St 2, Durham, NC 27705 | 2006-11-16 |
| 1700973930 | Drs. Turner & Butler Dmd Pa | Dentist | 2900 Croasdaile Dr, Suite 5, Durham, NC 27705-2579 | 2006-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194240671 | Wright and Associates Ix, Dds Pa | Dentist | 3020 S Miami Blvd Ste 200, Durham, NC 27703-9044 | 2017-08-07 |
| 1548570948 | Farzana Rahman | Dentist | 6208 Fayetteville Rd Ste 105, Durham, NC 27713 | 2010-10-19 |
| 1730320433 | Gary Roderick Tucker Jr. | Dentist | 5501 Fortunes Ridge Dr Ste H, Durham, NC 27713-6102 | 2009-03-10 |
| 1992975593 | Larry J. Moray, Dds, Ms, Pa | Dentist | 7011 Fayetteville Rd Ste 201, Durham, NC 27713-7748 | 2008-03-11 |
| 1760660385 | Lenk Orthodontics Pllc | Dentist | 12 Mathes Ter, Durham, NH 03824-2302 | 2008-02-06 |
| 1386855336 | Wesley Erwin King | Dentist | 2705 Chapel Hill Rd, Durham, NC 27707-1902 | 2007-05-24 |
| 1316078272 | Barbara Hershey | Dentist | 3206 Old Chapel Hill Rd, Durham, NC 27707-3688 | 2007-03-09 |
| 1568533719 | Ernest E. Wooden IIi | Dentist | 3925 N Duke St Ste 121, Durham, NC 27704-1780 | 2006-11-10 |
| 1437246238 | Robert Morgan Mason | Dentist | 2609 Carver St, Durham, NC 27705-2798 | 2006-10-05 |
| 1538133426 | Jack Dempsey Smith | Dentist | 2919 Colony Rd, Durham, NC 27705-5595 | 2006-02-15 |
| Find all providers in DURHAM | ||||
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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.