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

Jermaine Wilson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1730824947

Jermaine Wilson is a Student in an Organized Health Care Education/Training Program in Riverhead, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2022
Specialties on file
2

Practice location Address checks out

1732 Old Country Rd Unit D
Riverhead, NY 11901-3104
Phone: (631) 381-6205
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 063526 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1730824947
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 2, 2022
Last updated in NPPESSeptember 21, 2023
Certification dateJuly 19, 2023
Mailing address1732 Old Country Rd Unit D, Riverhead, NY 11901-3104

Other providers in Riverhead