Michael J Wiener, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

008178 Issued in CT

Practice address

921 State St
New Haven, CT 06511-3926

Phone

(203) 865-2245

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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 CT

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer Y. You, DMD, LLC

  • Dentist
  • New Haven, CT
  • NPI 1265853832
  NPD (past)
• Levy Dental Group, P.C.

  • Prosthodontics
  • New Haven, CT
  • NPI 1093729071

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1013053271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ALSTON AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065152002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 STATE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113926",
            "telephone_number": "203-865-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "008178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008001172",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Wiberg, SLP-CCC
• Christy Lynn Wichert, PA-C
• Abbott Cotton Widdicombe, M.D.
• Ilse R. Wiechers, MD
• Amy Virginia Wiegand, MS
• Gail Ann Wiggins
• Thilan Prasanga Wijesekera, M.D.
• Leslie E Wilborne, NCC
• Melissa Wilcoxson, APRN
• Amber Locklear Wilder, PA-C

• Periodontics in New Haven, CT
• Providers in New Haven, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.