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DR. SEDONNI SIMONE WILSON DDS
NPI 1861166803
Dentist in Los Angeles, CA

Active since August 03, 2021PECOS Enrolled
1500 S OLIVE ST, LOS ANGELES, CA 90015(213) 747-5542 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 25, 2021, Aug 3, 2021 (2 updates tracked since 2021).

About Dr. Sedonni Simone Wilson Dds NPPES

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

DR. SEDONNI SIMONE WILSON DDS (NPI 1861166803) is an individual dentist in Los Angeles, California, licensed in California (106158) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861166803
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. SEDONNI SIMONE WILSONCredential: DDS
Location Address1500 S OLIVE STLos Angeles, CA 90015-3023
Mailing Address801 S Berendo St Apt 603Los Angeles, CA 90005-4282
Phone(213) 747-5542
Sole ProprietorYes
Enumeration DateAugust 3, 2021
Last NPPES UpdateAugust 25, 20212 updates tracked since enumeration
NPPES CertifiedAugust 25, 2021
✔ NPI 1861166803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 106158
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.
1500 S OLIVE ST, Los Angeles, CA 90015
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana.Insurance ›

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. Sedonni Simone Wilson Dds 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 90015 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 18

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

AFRICA RENEE ROJAS RIVERA
Social Worker (Clinical)
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (213) 746-5582
BRENDA CORTEZ
Dental Hygienist
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (213) 747-5542
BERTHA VANESSA MENDOZA
Social Worker (Clinical)
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (323) 747-5542
CLAUDIA GOMEZ
Student in an Organized Health Care Education/Training Program
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (213) 747-5542
ROSA GARCIA
Case Manager/Care Coordinator
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (213) 747-5542
JANINA FABIAN ACSW
Social Worker (Clinical)
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (213) 746-5582
EVA V GARCIA CNM
Advanced Practice Midwife
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (213) 747-5542
EISNER PEDIATRIC AND FAMILY MEDICAL CENTER
Pharmacy (Clinic Pharmacy)
1500 S OLIVE ST
LOS ANGELES, CA 90015
Los Angeles County (213) 747-5542

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 Sedonni Wilson's NPI number?

The NPI number for Sedonni Wilson is 1861166803. It was assigned to this individual provider in the NPPES registry on August 3, 2021.

Where is Sedonni Wilson located?

Sedonni Wilson practices at 1500 S Olive St, Los Angeles, CA 90015. The listed phone number is (213) 747-5542.

What is Sedonni Wilson's specialty?

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

Is Sedonni Wilson enrolled in Medicare?

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

What insurance does Sedonni Wilson accept?

Health plans from Humana list Sedonni Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sedonni Wilson was last updated on August 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.