Provider Demographics
NPI:1598523177
Name:WILSON, NYLE KUNYRI (DDS)
Entity Type:Individual
Prefix:
First Name:NYLE
Middle Name:KUNYRI
Last Name:WILSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:NYLE
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:14901 RIVER CHASE CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-3387
Mailing Address - Country:US
Mailing Address - Phone:240-462-7242
Mailing Address - Fax:
Practice Address - Street 1:1005 DR. D B TODD JR BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program