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

Melinda Bautista Wilson, DMD

Individual provider Dentist · NPI 1780764555

Melinda Bautista Wilson, DMD is a Dentist in Los Angeles, California. Qualified in 1977, 49 years ago. Licensed in California.

Years since qualifying
49
Licensed in
CA
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1233 N Vermont Ave Ste 5
Los Angeles, CA 90029-1749
Phone: (323) 953-9471
Fax: (323) 953-9785
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 43610 (CA)

Record details

NPI number1780764555
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedOctober 16, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyDENTIST
Medical schoolOTHER
Graduated 1977 (49 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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