DR. WILSON PHILLIPS (NPI# 1144679499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144679499 |
| Entity Type | Individual |
| Full Name | DR. WILSON PHILLIPS |
| Credential | DMD |
| Practice Address |
1319 Lincoln Ave Prospect Park PA 19076-1216 |
| Mailing Address |
626 Snyder Ave Philadelphia PA 19148-2419 |
| Practice Telephone | 6105325008 |
| Mailing Telephone | 2679400300 |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2018-06-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN002360 | PA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PA STATE LICENSE NUMBER | DN002360 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 191 Presidential Blvd, Suite W4, Bala Cynwyd, PA 190041207 | 2679400300 |
| Street Address |
1319 LINCOLN AVE |
| City | PROSPECT PARK |
| State | PA |
| Zip Code | 19076-1216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710142625 | Rapozafamily Dentistry | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2008-07-21 |
| 1932558624 | Jared Gittleman | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2016-06-03 |
| 1336523141 | Anthony Jeffrey Rapoza | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2015-07-13 |
| 1184985640 | Katerina Sioutis | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2012-05-31 |
| 1740562883 | Chang Soon Park | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2011-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043616824 | Krista Mcshea Todd-burke | Occupational Therapist | 815 Chester Pike, Prospect Park Health and Rehabilitation Center, Prospect Park, PA 19076 | 2014-11-06 |
| 1558573774 | Family Chiropractic Wellness Center | Chiropractor | 625 Chester Pike, Prospect Park, PA 19076 | 2007-05-03 |
| 1265521900 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 762 Chester Pike, Prospect Park, PA 19076-0000 | 2006-10-12 |
| 1205453719 | Delaney Hallowell | Physician Assistant | 547 13th Ave, Prospect Park, PA 19076-1101 | 2020-06-30 |
| 1750633848 | Progressive Health Inc | Home Health | 705 15th Ave, Prospect Park, PA 19076-1105 | 2012-10-12 |
| 1538377551 | Health Access Network | Internal Medicine | 1401 Lincoln Ave, Prospect Park, PA 19076-1107 | 2007-05-21 |
| 1730185950 | Mukesh A Patel | Internal Medicine | 1421 Lincoln Ave, Prospect Park, PA 19076-1107 | 2005-06-22 |
| 1194019166 | Mukesh Patel M.d | Internal Medicine | 1421 Lincoln Ave, Prospect Park, PA 19076-1107 | 2011-06-07 |
| 1477093409 | Jenna Syken | Prevention Professional | 500 16th Ave, Prospect Park, PA 19076-1120 | 2017-02-23 |
| 1467065284 | Holcomb Associates Inc. | Clinic/Center | 500 16th Ave, Prospect Park, PA 19076-1120 | 2020-08-31 |
| Find all providers in zip 19076 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710142625 | Rapozafamily Dentistry | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2008-07-21 |
| 1588194914 | Mariam Beshara | Dentist | 222 Haledon Ave, Prospect Park, NJ 07508-2024 | 2017-06-18 |
| 1932558624 | Jared Gittleman | Dentist | 1319 Lincoln Ave, Prospect Park, PA 19076-1216 | 2016-06-03 |
| 1700149192 | Christy Marie Benjamin Lazaroff | Dentist | 907 Lincoln Ave, Prospect Park, PA 19076-1414 | 2012-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555426 | Andrew Morrison | Dentist | 1575 Highlands Dr Ste 100, Lititz, PA 17543-7507 | 2020-10-12 |
| 1497362982 | Samar Al Quraishi | Dentist | 625 E Lancaster Ave Apt C303, Wynnewood, PA 19096-2028 | 2020-09-28 |
| 1891301875 | Livewell Dentistry Pllc | Dentist | 125 Towne Centre Blvd Ste 510, Wexford, PA 15090-5619 | 2020-09-16 |
| 1396351318 | Mostafa Alwakeel | Dentist | 5450 Wissahickon Ave Apt B232, Philadelphia, PA 19144-5404 | 2020-09-16 |
| 1235743857 | Gurkirt Singh | Dentist | 833 N Bethlehem Pike, Spring House, PA 19477 | 2020-09-01 |
| 1245844927 | Puja Shah | Dentist | 602 S Bethlehem Pike Ste C2, Ambler, PA 19002-5800 | 2020-09-01 |
| 1932712759 | James Hickey | Dentist | 94 Egypt Hollow Rd, Warren, PA 16365 | 2020-08-31 |
| 1811508922 | Eleine Laffita Aguilera | Dentist | 4040 Spruce St Apt 5, Philadelphia, PA 19104-4130 | 2020-08-12 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1578172128 | Selena Nguyen | Dentist | 4837 N Broad St, Philadelphia, PA 19141-2107 | 2020-07-29 |
| Find all providers with the same taxonomy | ||||
| City | PROSPECT PARK |
| Zip Code | 19076 |
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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.