MICHAEL K. WILSON D.D.S.
NPI 1700079688
Dentist in Fair Oaks, CA

Active since August 23, 2007Opted out of Medicare · through Jun 16, 2027
11121 FAIR OAKS BLVD, FAIR OAKS, CA 95628(916) 961-6810(916) 961-6445 Get Directions Write a Review

NPPES record last updated: August 23, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Michael K. Wilson D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL K. WILSON D.D.S. (NPI 1700079688) is an individual dentist in Fair Oaks, California, licensed in California (29527) and active in the NPI registry since August 2007. He has opted out of Medicare through June 16, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1700079688
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMICHAEL K. WILSONCredential: D.D.S.
Location Address11121 FAIR OAKS BLVDFair Oaks, CA 95628-5136
Mailing Address11121 Fair Oaks BlvdFair Oaks, CA 95628-5136 · (916) 961-6810 · Fax (916) 961-6445
Fax(916) 961-6445
Sole ProprietorYes
Enumeration DateAugust 23, 2007
NPI 1700079688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in CA · 29527
Definition

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.

11121 FAIR OAKS BLVD, Fair Oaks, CA 95628

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Michael K. Wilson D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 16, 2015 through June 16, 2027.

Opt-Out Effective DateJune 16, 2015
Opt-Out In Effect ThroughJune 16, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95628 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$75.03 typical visit price
range $19.88 – $148.15
Typical copayment $18.75 (range $4.97 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
11121 FAIR OAKS BLVD
FAIR OAKS, CA 95628
Dentist
11121 FAIR OAKS BLVD
FAIR OAKS, CA 95628
Dentist
11121 FAIR OAKS BLVD
FAIR OAKS, CA 95628
Dentist
11121 FAIR OAKS BLVD
FAIR OAKS, CA 95628
Dentist
11121 FAIR OAKS BLVD
FAIR OAKS, CA 95628
Dentist (Orthodontics and Dentofacial Orthopedics)
11121 FAIR OAKS BLVD
FAIR OAKS, CA 95628

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Wilson's NPI number?

The NPI number for Michael Wilson is 1700079688. It was assigned to this individual provider in the NPPES registry on August 23, 2007.

Where is Michael Wilson located?

Michael Wilson practices at 11121 Fair Oaks Blvd, Fair Oaks, CA 95628. The listed phone number is (916) 961-6810.

What is Michael Wilson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Michael Wilson enrolled in Medicare?

No. Michael Wilson has opted out of Medicare through June 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Michael Wilson was last updated on August 23, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.