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

Jerry W Wilkins II, DA

Individual provider Dental Assistant · NPI 1538726567

Jerry W Wilkins II, DA is a Dental Assistant in Portland, Oregon. Licensed in Oregon and Washington. Registered with an NPI since 2019.

Licensed in
OR, WA
In the registry since
2019
Specialties on file
2

Practice location Address checks out

12750 SE Stark St Bldg E
Portland, OR 97233-1539
Phone: (971) 347-3009
Fax: (971) 256-3277
Show map & directions

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

Specialties & licences

Dental Assistant (primary) Taxonomy 126800000X · Licence 000525 (OR)
Dental Assistant Taxonomy 126800000X · Licence D160718103 (WA)

Record details

NPI number1538726567
Entity typeIndividual (Type 1)
GenderMale
Credentials DA
Sole proprietorNo
NPI enumeratedMay 24, 2019
Last updated in NPPESOctober 12, 2020
Certification dateOctober 12, 2020

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