DR. JAKE THOMAS WILDING (D.D.S) – Prosthodontics, NPI 1376975680
Prosthodontics
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
47 DENTIST in GA
Provider Addresses for DR. JAKE THOMAS WILDING (D.D.S)
TINGAY DENTAL CLINIC
320 W HOSPITAL RD
FT GORDON, GA 30509
Phone: (706) 787-5102
Type: Mailing
2401 S 31st St
Temple, TX 765080001
Phone: (254) 724-2111
Type: Location
PO BOX 844658
DALLAS, TX 752844658
Phone: (800) 994-0371
Type: Mailing
US ARMY DENTAL HEALTH ACTIVITY
36000 SHOEMAKER LANE, SUITE 1051
FORT CAVAZOS, TX 765447654
Phone: (254) 287-3105
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-11-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241127002165 | I | Dentist | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30509)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | TX | |
| U R O L O G Y | TX | |
| General Surgery | OK | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| - | TX | |
| Anesthesiology Assistant | TX | |
| - | TX | |
| - | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| - | TX |
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