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DR. KENT WILLIAM WILSON D.D.S.
NPI 1700208576
Dentist - General Practice in South Pasadena, CA

Active since January 14, 2014PECOS Enrolled
1941 HUNTINGTON DR, SUITE B, SOUTH PASADENA, CA 91030(626) 441-1167(626) 331-3378 Get Directions Write a Review

NPPES record last updated: January 14, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kent William Wilson D.d.s. NPPES

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

DR. KENT WILLIAM WILSON D.D.S. (NPI 1700208576) is an individual general practice provider in South Pasadena, California, licensed in California (25654) and active in the NPI registry since January 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700208576
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. KENT WILLIAM WILSONCredential: D.D.S.
Location Address1941 HUNTINGTON DR, SUITE BSouth Pasadena, CA 91030-4967
Mailing Address1941 Huntington Dr, Suite BSouth Pasadena, CA 91030-4967 · (626) 441-1167 · Fax (626) 331-3378
Phone(626) 441-1167
Fax(626) 331-3378
Sole ProprietorYes
Enumeration DateJanuary 14, 2014
✔ NPI 1700208576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 25654
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1941 HUNTINGTON DR, South Pasadena, CA 91030
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kent William Wilson D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91030 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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 9

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

DR. JAMES A MACCUISH M.D.
Specialist
1941 HUNTINGTON DR, SUITE E
SOUTH PASADENA, CA 91030
Los Angeles County (626) 799-5450
FREDERICK R. HARRIS, O.D., INC.
Optometrist
1941 HUNTINGTON DR, SUITE F
SOUTH PASADENA, CA 91030
Los Angeles County (626) 799-2212
DR. JAMES CARLTON HODGE JR. D.D.S.
Dentist (General Practice)
1941 HUNTINGTON DR, SUITE H
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-1139
DR. TONY S HWANG DDS
Dentist (Pediatric Dentistry)
1941 HUNTINGTON DR, SUITE #A
SOUTH PASADENA, CA 91030
Los Angeles County (626) 308-1807
CHRISTOPHER BIGLEY DDS
Dentist (General Practice)
1941 HUNTINGTON DR, SUITE H
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-1139
JENNIFER CHEN, DDS, INC.
Clinic/Center (Dental)
1941 HUNTINGTON DR, SUITE H
SOUTH PASADENA, CA 91030
Los Angeles County (626) 441-1139
TONY S. HWANG DDS, INC
Dentist (Pediatric Dentistry)
1941 HUNTINGTON DR, SUITE #A
SOUTH PASADENA, CA 91030
Los Angeles County (626) 308-1807
DR. FREDERICK R HARRIS O.D.
Optometrist
1941 HUNTINGTON DR, SUITE F
SOUTH PASADENA, CA 91030
Los Angeles County (626) 799-2212

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 Kent Wilson's NPI number?

The NPI number for Kent Wilson is 1700208576. It was assigned to this individual provider in the NPPES registry on January 14, 2014.

Where is Kent Wilson located?

Kent Wilson practices at 1941 Huntington Dr Suite B, South Pasadena, CA 91030. The listed phone number is (626) 441-1167.

What is Kent Wilson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Kent Wilson enrolled in Medicare?

Yes. Kent Wilson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kent Wilson was last updated on January 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.