Individual provider Active NPI

Austin Mathew Wessell, D.D.S.

  • General Practice Dentistry
  • Verona, WI
National Provider Identifier
1093128928
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7275-15 Issued in WI
Practice address
271 S Main St
Verona, WI 53593-1470
Phone
(608) 845-6612
NPI assigned
Jun 9, 2014
Last updated
Jun 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7275-15 WI Primary

Addresses

Primary practice location

271 S Main St
Verona, WI 53593-1470

Mailing address

271 S Main St
Verona, WI 53593-1470
Phone (608) 845-6612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20150603001738 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2163743022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Verona Family Dental LLC General Practice Past Accepting new patients
Kelsey MP Hostetler DDS, SC PastSince May 3, 2020 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1093128928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 S MAIN ST",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931470",
            "telephone_number": "608-845-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 S MAIN ST",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931470",
            "telephone_number": "608-845-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSELL",
        "first_name": "AUSTIN",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "7275-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

Verify at the official NPI Registry.