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1629141981 NPI number — CAROLINA ARIAS WILSON D.M.D.

NPI Number: 1629141981
Health Care Provider/Practitioner: CAROLINA ARIAS WILSON D.M.D.

Information about “1629141981” NPI (CAROLINA ARIAS WILSON D.M.D.) exists in 1629141981 in HTML format HTML  |  1629141981 in plain Text format TXT  |  1629141981 in PDF (Portable Document Format) PDF  |  1629141981 in an XML format XML  formats.

NPI Number : 1629141981 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629141981",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WILSON",
    "FirstName": "CAROLINA",
    "MiddleName": "ARIAS",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9217 PARK WEST BLVD",
    "SecondLineMailingAddress": "SUITE A-1",
    "MailingAddressCityName": "KNOXVILLE",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37923-4404",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "865-539-4494",
    "MailingAddressFaxNumber": "865-539-4034",
    "FirstLinePracticeLocationAddress": "10000 KINGSTEN PIKE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KNOXVILLE",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37922",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "865-539-4494",
    "PracticeLocationAddressFaxNumber": "865-539-4034",
    "EnumerationDate": "11/16/2006",
    "LastUpdateDate": "05/17/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "5072",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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