TRACY L. WILKERSON, DDS, PLLC (NPI# 1760501001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760501001 |
| Entity Type | Organization |
| Organization Name | TRACY L. WILKERSON, DDS, PLLC |
| Other Organization Name | CHILDREN'S DENTISTRY |
| Practice Address |
1400 Kanawha Blvd E Charleston WV 25301-3002 |
| Practice Telephone | 3043450541 |
| Practice Fax Number | 3043458718 |
| Mailing Telephone | 3043450541 |
| Mailing Fax Number | 3043458718 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. TRACY LYNN WILKERSON (PEDIATRIC SPECIALIST) |
| Authorized Official Telephone | 3043450541 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3529 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 4005111000 | 05 | |
| WV | 3810005586 | 05 | |
| WV | INDIVIDUAL NPI | 1528024460 | 01 |
| Other Name | Type Code |
|---|---|
| Children's Dentistry | Doing Business As Name - Organization |
| Street Address |
1400 KANAWHA BLVD E |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25301-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087680 | Kerrie Rena Harris | Counselor | 16 Leon Sullivan Way Suite 300, Charleston, WV 25301 | 2020-09-15 |
| 1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1740638022 | Christina Phalen | Pharmacy Technician | 701 Lee Street East, Charleston, WV 25301 | 2016-05-27 |
| 1366867079 | Brooke Powell Garnes | Speech-Language Pathologist | 1313 Quarrier Street, Suite A, Charleston, WV 25301 | 2014-03-04 |
| 1952648404 | Implanted Pump Management, LLC | Home Infusion | 311 Laidley St., Suite 202, Charleston, WV 25301 | 2013-01-03 |
| 1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
| 1033477278 | James Stephen Harman | Neurological Surgery | 415 Morris St Ste 400, Charleston, WV 25301 | 2012-04-25 |
| 1265674329 | Howard and Howard Dental LLC | Dentist | 1321 Virginia St., Charleston, WV 25301 | 2009-04-03 |
| 1881856144 | Steven David Hollosi | Emergency Medicine | 501 Morris St., Charleston, WV 25301 | 2008-06-27 |
| Find all providers in zip 25301 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669726048 | Dentistry for Children of South Carolina, PC | Dentist | 808 Wappoo Rd, Charleston, SC 29407 | 2012-11-06 |
| 1346464674 | Cornerstone Children's Dentistry, P.a. | Dentist | 2075-a Charlie Hall Blvd., Charleston, SC 29414-5834 | 2007-04-11 |
| 1902902992 | Erin Lewis Nichols | Dentist | 1721 Oak Point Rd, Charleston, SC 29412-2838 | 2006-09-16 |
| 1104874924 | Howard Peskin | Dentist | 494 Savannah Hwy, Charleston, SC 29407-7275 | 2006-05-04 |
| 1528024460 | Tracy Lynn Wilkerson | Dentist | 1400 Kanawha Boulevard East, Charleston, WV 25301 | 2006-04-20 |
| 1720061005 | Paul A. Galloway | Dentist | 2075 Charlie Hall Blvd, Suite A, Charleston, SC 29414-5834 | 2005-11-21 |
| 1164427795 | Ashley Jane Patnoe | Dentist | 1538b Kanawha Blvd E, Charleston, WV 25311-2413 | 2005-06-20 |
| 1922620871 | Alex Emily Sherman | Dentist | 169 Ashley Ave, Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2020-05-14 |
| 1952783094 | Karen Konomi Wolf | Dentist | 808 Wappoo Rd, Charleston, SC 29407-5865 | 2015-06-25 |
| 1740621036 | Don E. Skaff, Dds, Inc. | Dentist | 4502 Maccorkle Ave Se, Suite C, Charleston, WV 25304-1835 | 2013-07-15 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25301 |
Please comment or provide details below to improve the information on TRACY L. WILKERSON, DDS, 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.