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

Individual provider Dental Hygienist · NPI 1043216807

Mr. Jack Anthony Wilson, RDHAP is a Dental Hygienist in National City, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2005
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Practice location Address checks out

2654 Stacey Way
National City, CA 91950-7760
Phone: (559) 289-8293
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Hygienist (primary) Taxonomy 124Q00000X · Licence HAP 299 (CA)

Record details

NPI number1043216807
Entity typeIndividual (Type 1)
GenderMale
Credentials RDHAP
Sole proprietorYes
NPI enumeratedJune 24, 2005
Last updated in NPPESJuly 15, 2014

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