Theodore John Willmann, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16658 Issued in OH

Practice address

570 E Kremer Hoying Rd # D
Saint Henry, OH 45883-9613

Phone

(419) 678-8000

Fax

(419) 678-4409

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013048362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 E KREMER HOYING RD # D",
            "city": "SAINT HENRY",
            "state": "OH",
            "postal_code": "458839613",
            "telephone_number": "419-678-8000",
            "fax_number": "419-678-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 E KREMER HOYING RD # D",
            "city": "SAINT HENRY",
            "state": "OH",
            "postal_code": "458839613",
            "telephone_number": "419-678-8000",
            "fax_number": "419-678-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMANN",
        "first_name": "THEODORE",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "16658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "16658",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean I Stachler
• Ralph Stachler
• Kristine L Strawniak, D.C.
• Taylor Thwaits
• Linda Wellman, NPC
• Samantha Wourms

• General Practice Dentistry in Saint Henry, OH
• Providers in Saint Henry, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.