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Deactivated NPI 1205965449 Deactivated / Inactive NPI Male Practitioner

Dr. John T Wilson , DMD, PhD, PC

Dentist • Brunswick, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 05, 2007
NPI Deactivation Date January 31, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. John Wilson, DMD, PhD, PC was a registered Dentist practicing in Brunswick, GA. Throughout an active medical career spanning 15 years, Dr. Wilson provided care at the practice location at 1515 TILLMAN AVE until profile deactivation on 2022-01-31.

Practice Location & Contact Primary Location

Practice Address

1515 Tillman Ave

Brunswick, GA 315206933

Telephone 9122620542
Fax 9122626538
Associated Practice Facility / Clinic
🏢 Dr John T Wilson Pc Facility NPI 1275662439

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Brunswick, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.3 Yrs
Regional Practice Density
13 Specialists

Practicing in Brunswick, GA (2164 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License GA 010583

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Heather Wilson , DMD

Dentist - General Practice

NPI 1861511917

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 31, 2022

Record deactivated on January 31, 2022

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 1515 TILLMAN AVE, BRUNSWICK, GA 315206933 (Tel: 9122620542)

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Updated Business Mailing Address July 09, 2007

Registered at 1515 TILLMAN AVE, BRUNSWICK, GA 315206933 (Tel: 9122620542)

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Provider Name / Credentials Updated July 09, 2007

Recorded as JOHN WILSON, DMD, PHD, PC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Dentist (License #010583 in GA)

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Initial NPI Registration & Enumeration March 05, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205965449
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 05, 2007
Last Update: July 09, 2007
Deactivation Date: January 31, 2022

Mailing Address

1515 Tillman Ave

Brunswick, GA 315206933

Phone: 9122620542

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.