Benjamin Thomas Wietecha, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8293 Issued in SC

Practice address

10 Medical Park
Dental Center
Columbia, SC 29203

Phone

(803) 434-6567

Fax

(803) 434-6299

NPI assigned

Sep 5, 2013

Last updated

Sep 5, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in SC

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

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1093140360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PARK",
            "address_2": "DENTAL CENTER",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6567",
            "fax_number": "803-434-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PARK",
            "address_2": "DENTAL CENTER",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6567",
            "fax_number": "803-434-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETECHA",
        "first_name": "BENJAMIN",
        "middle_name": "THOMAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Widener, M.D.
• Rebecca W Widener, MD.
• Paul E Widmayer, MSRD
• Anna K Wiegner, FNP-BC
• Matthew M Wienecke, MD
• Scott C Wietecha, DMD
• Billy W. Wiggins, RN
• Janelle Wiggins
• Karen Clarke Wiggins, RN
• Sophia Wijthoff, DPT

• Dentist in Columbia, SC
• Providers in Columbia, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.