DR. LORI S WILSON (NPI# 1861409203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861409203 |
| Entity Type | Individual |
| Full Name | DR. LORI S WILSON |
| Credential | DDS |
| Practice Address |
2010 Wakefield Ave Petersburg VA 23805-2112 |
| Practice Telephone | 8047336740 |
| Practice Fax Number | 8047338687 |
| Mailing Telephone | 8047336740 |
| Mailing Fax Number | 8047338687 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0401411164 | VA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | UNITED CONCORDIA | 1335151 | 01 |
| VA | AETNA | 7996766 | 01 |
| VA | BLUE CROSS/ BLUE SHIELD | 199459 | 01 |
| VA | 9179631 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427665660 | Lori Lyn Wilson | Peer Specialist | 12700 Sw 53rd St, Mustang, OK 73064-7257 | 2020-09-30 |
| 1588205058 | Lori Wilson | Registered Nurse | 5512 Canyon Bluff Ln, Rosharon, TX 77583-2091 | 2019-10-04 |
| 1538401344 | Lori Rhae Wilson | Rehabilitation Practitioner | 1620 Granite Dr, Reno, NV 89509-3997 | 2013-03-19 |
| 1528344611 | Lori A. Wilson | Speech-Language Pathologist | 3830 Paulding Ave., Lavelle School for The Blind, Bronx, NY 10469 | 2011-11-02 |
| 1518274505 | Lori Anne Wilson | Acupuncturist | 3010 5th Ave, San Diego, CA 92103-5841 | 2010-09-11 |
| 1679727010 | Lori N Wilson | Marriage & Family Therapist | 615 Piikoi St., #203, Honolulu, HI 96814 | 2008-11-12 |
| 1629256409 | Lori Sue Wilson | Counselor | 2480 N Palo Verde Blvd, #103, Tucson, AZ 85716-2548 | 2008-02-04 |
| 1134340714 | Lori Anne Wilson | Psychologist | 6602 N. 75th Ave, Glendale, AZ 85303-3536 | 2007-05-01 |
| 1417970682 | Lori B Wilson | Midwife, Lay | 2211 N Weber St, Colorado Springs, CO 80907-6946 | 2006-07-26 |
| 1548256498 | Lori L Wilson | Surgery | 263 Farmington Ave, Mc 1614, Neag Comprehensive Cancer Center - Surg Onc, Farmington, CT 06030-0001 | 2005-09-26 |
| Street Address |
2010 WAKEFIELD AVE |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750403911 | Childrens Endodontic Services, PC | Dentist | 2010 Wakefield Ave, Petersburg, VA 23805-2112 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| 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 |
|---|---|---|---|---|
| 1568973725 | Milan Bhagat, Dmd, Pllc | Dentist | 3277 S Crater Rd Ste B, Petersburg, VA 23805-9285 | 2017-10-16 |
| 1285936872 | Donald P. Hartman | Dentist | 213 N 5th, Petersburg, IL 62675-1303 | 2010-12-02 |
| 1952573297 | John W Lynn Dds Ltd | Dentist | 104 Morton Avenue, Petersburg, VA 23805 | 2008-03-27 |
| 1326260621 | Philip Gaither Beardslee | Dentist | 608 S Nordic, Petersburg, AK 99833 | 2007-05-03 |
| 1114143203 | David Arnold Spencer | Dentist | 806 S Nordic, Petersburg, AK 99833-0469 | 2007-04-17 |
| 1770607616 | James Keith Johnson | Dentist | 6204 Duncan Rd, Petersburg, VA 23803-7442 | 2007-03-17 |
| 1578621645 | Jeffrey G Kimble | Dentist | 211 Virginia Avenue, Petersburg, WV 26847 | 2006-12-04 |
| 1538248778 | Raymond Gibson Smith Jr. | Dentist | Seventh Avenue, Hiram Davis Medical Center, Petersburg, VA 23803 | 2006-11-06 |
| 1801974621 | Charles Francis Griffin | Dentist | 3277 S Cratrer Rd, Petersburg, VA 23805 | 2006-11-01 |
| 1477648905 | Hugh Coleman Dowdy | Dentist | 700 S. Sycamore St, 17, Petersburg, VA 23803-5802 | 2006-10-03 |
| Find all providers in PETERSBURG | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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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.