Healthcare Provider Details

I. General information

NPI: 1003522038
Provider Name (Legal Business Name): DAKOTA ARIC WILCOX DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 LIBERTY VILLAGE DR
WARREN NJ
07059-2711
US

IV. Provider business mailing address

307 LIBERTY VILLAGE DR
WARREN NJ
07059-2711
US

V. Phone/Fax

Practice location:
  • Phone: 920-229-0870
  • Fax:
Mailing address:
  • Phone: 920-229-0870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6048-12
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00798200
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7059
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: