DR. K. P. WILSON, PLLC (NPI# 1700984689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700984689 |
| Entity Type | Organization |
| Organization Name | DR. K. P. WILSON, PLLC |
| Other Organization Name | WILSON MARTINO DENTAL OF BRIDGEPORT |
| Practice Address |
930 W Main St Bridgeport WV 26330-1673 |
| Mailing Address |
516 Cost Ave Stonewood WV 26301-4811 |
| Practice Telephone | 3048427568 |
| Practice Fax Number | 3048422202 |
| Mailing Telephone | 3046245250 |
| Mailing Fax Number | 3046245251 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT V MARTINO (CEO) |
| Authorized Official Telephone | 3046245250 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3070 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | WV DENTAL MEDICAL CARD | 3810001853 | 01 |
| Other Name | Type Code |
|---|---|
| Wilson Martino Dental of Bridgeport | Doing Business As Name - Organization |
| Street Address |
930 W MAIN ST |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-1673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073139556 | Magy Mckary | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2020-06-22 |
| 1659722429 | Jennifer Ann Miles | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2016-06-23 |
| 1679849186 | Andrew Thompson | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2012-03-29 |
| 1760580781 | Patrick J Cobb | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2006-09-21 |
| 1518065960 | Kenneth P Wilson | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2006-09-20 |
| 1669570081 | Robert V Martino | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2006-09-20 |
| 1255439378 | Adam M Fowler | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891355814 | Kristopher Antonio Yen | Dentist | 32 Kathryn Dr, Bridgeport, CT 06610-1264 | 2019-06-20 |
| 1407239379 | Oliver Sun | Dentist | 3885 Main St Ste 101, Bridgeport, CT 06606-2814 | 2015-07-09 |
| 1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
| 1588064349 | Siz, LLC | Dentist | 1041-1043 East Main Street, Bridgeport, CT 06608-1916 | 2014-08-29 |
| 1306269758 | Dr.dental of Bridgeport PC | Dentist | 1700 Park Ave., Bridgeport, CT 06604-3826 | 2014-01-21 |
| 1700144714 | Hamed Ghorbani-moghaddam | Dentist | 2690 E Main St, Columbia Dental, Bridgeport, CT 06610-1422 | 2012-04-26 |
| 1831476050 | Dental Centers of Fairfiled County LLC | Dentist | 140 Hurd Ave, Bridgeport, CT 06604-2701 | 2011-11-16 |
| 1124308184 | Family Dentistry of Bridgeport P.C. | Dentist | 90 Brooklawn Ave, Bridgeport, CT 06604-2010 | 2011-08-23 |
| 1861789034 | Bridgeport Dental Care, LLC | Dentist | 2417 E Main St, Bridgeport, CT 06610-1802 | 2011-07-07 |
| 1154628477 | Bridgeport Dentist | Dentist | 2992 Main St, Bridgeport, CT 06606-4226 | 2011-02-23 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on DR. K. P. WILSON, PLLC.
| 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.