ANTIONETTE C WILSON DDS NPI 1437321742

NPI Information

NPI: 1437321742
Provider Name: ANTIONETTE C WILSON, DDS
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
2127 E VICTORY DR
SAVANNAH, GA
ZIP 31404
Phone: (912) 443-6013
Get Directions

Antionette C Wilson, DDS is a pediatric dentistry dentist in Savannah, GA. The provider is 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. Antionette C Wilson, DDS NPI is 1437321742. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2127 E VICTORY DR
SAVANNAH, GA
ZIP 31404-917
Phone: (912) 443-6013
Fax: (912) 443-6014

The enumeration date for this NPI number is 3/26/2008 and was last updated on 3/26/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	DEN1000575	DISTRICT OF COLUMBIA	No
2	1223G0001X	Dentist	General Practice	0401411580	VIRGINIA	No
3	1223G0001X	Dentist	General Practice	13970	MARYLAND	No
4	1223P0221X	Dentist	Pediatric Dentistry	DN013695	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	428641977A	MEDICAID	GEORGIA
2	ZG3695	MEDICAID	SOUTH CAROLINA
3	2039744	OTHER	GEORGIA	UNITED CONCORDIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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