Matthew Renner Wimmer, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN-10144 Issued in CO

Practice address

6690 S. Broadway
Centennial, CO 80121

Phone

(303) 794-6339

Fax

(248) 967-7794

NPI assigned

Jul 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1033349774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6690 S. BROADWAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80121",
            "telephone_number": "303-794-6339",
            "fax_number": "248-967-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6690 S. BROADWAY",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80121",
            "telephone_number": "303-794-6339",
            "fax_number": "248-967-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMMER",
        "first_name": "MATTHEW",
        "middle_name": "RENNER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-15",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901020070",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN-10144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirby W Wilson, PT
• Michaela Joy Wilson
• Parker Wilson, PSY.D.
• Neal Kirkman Wilsted, DDS
• Jessica R Wilts, PHARMD
• Andrew Taylor Winans, RBT-17-33515
• Cindy Winar, LPC
• Erica L. Windle, DC
• Ashlynn Winemiller-Edmond, RBT
• Kimberly Ann Wingate, LPN

• General Practice Dentistry in Centennial, CO
• Providers in Centennial, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.