Lewis Clark Wilde, DDS

Dentist · Gallup, NM

Individual Active NPI

NPI number 1922673599

Practice location

1601 S Second St
Gallup, NM 87301-5816
Phone
(505) 722-4422
Fax
(505) 722-2060

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NPI record

NPI
1922673599
Entity type
Individual (Type 1)
Enumeration date
May 25, 2021
Last updated
July 6, 2021
Certified
July 6, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DD5467 NM
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

2001 Mariyana Ave
Gallup, NM 87301-5627
Phone
(435) 669-0156

About Dr. Wilde

Lewis Clark Wilde, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1601 S Second St, Gallup, NM 87301-5816. The NPI number 1922673599 was assigned on May 25, 2021 and the record was last updated on July 6, 2021.

Dr. Wilde lists a license in the registry: #DD5467 (NM) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Lewis Clark Wilde, DDS?

The NPI number is 1922673599.

What is the phone number of Dr. Wilde?

The phone number listed for the practice location is (505) 722-4422.

Where is Dr. Wilde located?

1601 S Second St, Gallup, NM 87301-5816.

What is the taxonomy code for Dr. Wilde?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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