DR. JEFFREY DOUGLAS WILSON (NPI# 1104822394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104822394 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY DOUGLAS WILSON |
| Credential | D.M.D. |
| Practice Address |
13728 Office Park Ct Bayonet Point FL 34667-7144 |
| Practice Telephone | 7278639669 |
| Practice Fax Number | 7278628907 |
| Mailing Telephone | 7278639669 |
| Mailing Fax Number | 7278628907 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
14685 | FL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | UNITED CONCORDIA | 539190 | 01 |
| FL | BLUE CROSS BLUE SHEILD | 54987 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720505274 | Jeffrey L Wilson | Counselor | 14201 S Mur Len Rd Ste 101, Olathe, KS 66062-1859 | 2017-08-25 |
| 1700317153 | Jeffrey Wilson | Student in an Organized Health Care Education/Training Program | Florida Atlantic University Internal Medicine Residency, 800 Meadows Road, Boca Raton, FL 33486 | 2017-03-27 |
| 1962955435 | Jeffrey John Wilson | Specialist/Technologist | 24062 Taft Rd, Novi, MI 48375-3022 | 2016-08-01 |
| 1073909883 | Jeffrey Lynn Wilson | Clinical Nurse Specialist | 5516 Barons Pt, Ooltewah, TN 37363-8875 | 2015-04-08 |
| 1801185814 | Jeffrey Matthew Wilson | Registered Nurse | 7750 Via Francesco Unit 2, San Diego, CA 92129-5149 | 2011-03-30 |
| 1447425798 | Jeffrey Joseph Wilson | Dentist | 1542 Union St, Schenectady, NY 12309 | 2008-04-28 |
| 1184701658 | Jeffrey M Wilson | Dentist | 73 Greentree Dr # 407, Dover, DE 19904-7646 | 2006-11-01 |
| 1922108745 | Jeffrey Lynn Wilson | Family Medicine | 1810 Eldron Blvd., Se, Palm Bay, FL 32909 | 2006-09-22 |
| 1184727612 | Jeffrey F Wilson | Optometrist | 126 W Wheatland Ave, Remus, MI 49340 | 2006-09-07 |
| 1417065715 | Jeffrey Whiteside Wilson | Psychiatry & Neurology | 10229 W Greenfield Ave, West Allis, WI 53214 | 2006-08-27 |
| Street Address |
13728 OFFICE PARK CT |
| City | BAYONET POINT |
| State | FL |
| Zip Code | 34667-7144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386640449 | Stephen Michael Durrett | Dentist | 13728 Office Park Ct, Bayonet Point, FL 34667-7144 | 2005-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417571431 | Andrea E Steyer | Speech-Language Pathologist | 7927 Sr-52 W, Hudson, FL 34667 | 2020-06-05 |
| 1760956288 | Helen Edith Yaworski | Emergency Medicine | Bayonet Point Emergency Department, 14000 Fivay Rd, Hudson, FL 34667 | 2019-01-17 |
| 1104308329 | Mark Felix Roldan | Nurse Practitioner | 13944 Lakeshore Blvd Ste C, Hudson, FL 34667 | 2018-09-04 |
| 1285181867 | Dawnlee Basile-wood | Counselor | 9416 Dibot Court, Hudson, FL 34667 | 2016-09-01 |
| 1679951321 | Joseph Robbins | Internal Medicine | 14000 Fivay Road, Hudson, FL 34667 | 2015-05-14 |
| 1043602733 | Martiale Faustin | Registered Nurse | 12715 Clock Tower Pkwy, Hudson, FL 34667 | 2015-03-04 |
| 1720418015 | Olive Spoeth | Assisted Living Facility | 8711 Cutlass Dr., Hudson, FL 34667 | 2013-11-22 |
| 1891093365 | Saxon Rehab Management LLC. | Occupational Therapist | 12404 Cobblestone Dr, Hudson, FL 34667 | 2011-03-08 |
| 1174768055 | Anthony Charles Stover | Behavioral Analyst | 14610 Conner Drive, Hudson, FL 34667 | 2008-12-08 |
| 1356594451 | Jill Bona Garcia | Speech-Language Pathologist | 11820 Denton Ave, Hudson, FL 34667 | 2008-11-03 |
| Find all providers in zip 34667 | ||||
| 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 |
|---|---|---|---|---|
| 1194873869 | Burton Marc Golub | Dentist | 12427 Clock Tower Pkwy, Bayonet Point, FL 34667-2411 | 2007-01-08 |
| 1487750378 | Lake View Family Dentistry Pa | Dentist | 13728 Office Park Court, Bayonet Point, FL 34667 | 2006-09-16 |
| 1386640449 | Stephen Michael Durrett | Dentist | 13728 Office Park Ct, Bayonet Point, FL 34667-7144 | 2005-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326843 | Stellar Smiles Inc. | Dentist | 1501 Corporate Dr Apt 311, Boynton Beach, FL 33426-6600 | 2020-11-07 |
| 1962003269 | Magic Touch Dentistry, P.a. | Dentist | 2 Oakwood Blvd Ste 150a, Hollywood, FL 33020-1960 | 2020-11-03 |
| 1982203584 | Crystel Ananos Riggs Dmd Pa | Dentist | 900 Se Ocean Blvd Ste 248, Stuart, FL 34994-3501 | 2020-10-23 |
| 1053910315 | Dental Buddies of Vero Beach | Dentist | 3755 7th Ter Ste 303, Vero Beach, FL 32960-6547 | 2020-10-19 |
| 1295332013 | Dentists of Nona, Pa | Dentist | 14019 Narcoossee Rd Ste 135, Orlando, FL 32832-7162 | 2020-10-05 |
| 1073110177 | Coral Springs Dental Group, LLC | Dentist | 2029 N University Dr, Coral Springs, FL 33071-6132 | 2020-10-02 |
| 1316554686 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 15800 Orange Blvd, Loxahatchee, FL 33470-3442 | 2020-09-30 |
| 1861009136 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 5068 W State Road 46, Sanford, FL 32771-9246 | 2020-09-30 |
| 1003423922 | Aurora Dental Group, P.a | Dentist | 6176 Sw 8 Street, Miami, FL 33144 | 2020-09-24 |
| 1063029122 | Steven Gross | Dentist | 2021 Ne 210th St, Miami, FL 33179-1629 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
| City | BAYONET POINT |
| Zip Code | 34667 |
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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.