PHILLIP DUANE WILSON (NPI# 1215144910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215144910 |
| Entity Type | Individual |
| Full Name | PHILLIP DUANE WILSON |
| Credential | D.D.S. |
| Practice Address |
716 Stevens Ave Portland ME 04103-2693 |
| Practice Telephone | 2072830171 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-02-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DEN4754 | ME | Dental Providers |
| N | 122300000X | Dentist | 16752 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568435 | Phillip Wilson | Pharmacist | 2802 W Kingshighway, Paragould, AR 72450-2617 | 2020-11-06 |
| 1912543273 | Phillip E Wilson | Behavior Technician | 801 Jefferson St Ste 45&6, Fairfield, CA 94533-5557 | 2019-11-21 |
| 1427462761 | Phillip Ryan Wilson II | Anesthesiology | 169 Ashley Ave, Room 202 Main Hospital, Charleston, SC 29425 | 2014-06-14 |
| 1457667172 | Phillip Wilson | Case Manager/Care Coordinator | 2413 2nd St, Eureka, CA 95501-0811 | 2010-08-19 |
| 1265686281 | Phillip Egbert Wilson | Psychiatry & Neurology | 324 10th Ave Ste 154, Salt Lake City, UT 84103-2876 | 2008-11-05 |
| 1053493155 | Phillip Lee Wilson | Audiologist | 1966 Inwood Rd, Dallas, TX 75235-7298 | 2006-10-19 |
| 1669471546 | Phillip Wilson | Dentist | Hwy 56 & 270 Junction, Wewoka, OK 74884 | 2005-07-21 |
| Street Address |
716 STEVENS AVE |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-2693 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245990 | Lee Edward Niemeyer | Dentist | 716 Stevens Ave, Portland, ME 04103-2656 | 2005-06-20 |
| 1710505433 | Colin Hulst | Registered Nurse | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-07-09 |
| 1346864279 | Lievin Umba | Physician Assistant | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-06-06 |
| 1184248312 | Wendy Letchworth | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-06-03 |
| 1619591930 | Geoffrey Kamau Wahome | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-06-02 |
| 1891319398 | Jordan Ray Kelley | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2693 | 2020-06-01 |
| 1073137659 | Jaclyn Elizabeth Masters | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-05-30 |
| 1508480260 | Carla D'amour | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-05-28 |
| 1003439779 | Matthew Scott Austin | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2656 | 2020-05-28 |
| 1598389256 | Novisi Abba | Student in an Organized Health Care Education/Training Program | 716 Stevens Ave, Portland, ME 04103-2693 | 2020-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| 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 |
|---|---|---|---|---|
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1972117588 | Medical Teams International | Dentist | 14150 Sw Milton Ct, Portland, OR 97224-8024 | 2020-09-01 |
| 1255975561 | Michigan Sleep Solutions LLC | Dentist | 8037 Abbey Rd., Portland, MI 48875-9774 | 2019-10-30 |
| 1073162699 | Ryan Douglas Mccormick | Dentist | 3620 Se Powell Blvd Ste 200, Portland, OR 97202-1880 | 2019-09-06 |
| 1255989497 | Owen Ritter Lund | Dentist | 4224 Ne Halsey St Ste 330, Portland, OR 97213-1568 | 2019-08-30 |
| 1023663119 | Xiaochen Zhou | Dentist | 2824 Ne Wasco St Ste 200, Portland, OR 97232-1772 | 2019-08-06 |
| 1598223919 | Portland Modern Dentistry | Dentist | 5175 Ne Martin Luther King Blvd Ste 110, Portland, OR 97211-3233 | 2019-03-05 |
| 1922571942 | Rashmi, LLC | Dentist | 553 Portland Cobalt Rd Unit 1, Portland, CT 06480-1968 | 2019-01-03 |
| 1053891051 | Waleed Almulla | Dentist | 8401 Ne Halsey St Ste 102, Portland, OR 97220-5670 | 2018-08-19 |
| 1558848333 | Kelsey Mcevoy | Dentist | 11805 Nw Cedar Falls Dr Ste 101, Portland, OR 97229-2780 | 2018-07-24 |
| Find all providers in PORTLAND | ||||
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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.