Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kathi Ann Wilson, DDS

Individual provider Dentist · NPI 1144291477

Dr. Kathi Ann Wilson, DDS is an Oral Surgery in Grand Rapids, Michigan. Qualified in 2000, 26 years ago. Licensed in Michigan.

Years since qualifying
26
Licensed in
MI
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

4820 Cascade Rd SE
Grand Rapids, MI 49546-3785
Phone: (616) 454-1482
Fax: (855) 536-4347
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 17948 (MI)

Record details

NPI number1144291477
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorNo
NPI enumeratedJanuary 26, 2006
Last updated in NPPESMarch 11, 2025
Certification dateMarch 11, 2025
Mailing address4820 Cascade Rd Se, Grand Rapids, MI 49546-3785

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Accepts Medicare assignment Not indicated

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