Robert Carl Wunderle, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN008930 Issued in GA

Practice address

1000 Johnson Ferry Rd
BLDG H
Marietta, GA 30068-5518

Phone

(770) 977-0364

Fax

(678) 819-6531

NPI assigned

May 27, 2005

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Atlanta Oral & Facial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Marietta, GA
  • NPI 1992738165
  Medicare reassignment NPD

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1093718645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "address_2": "BLDG H",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685518",
            "telephone_number": "770-977-0364",
            "fax_number": "678-819-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "address_2": "BLDG H",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685518",
            "telephone_number": "770-977-0364",
            "fax_number": "678-819-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLE",
        "first_name": "ROBERT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN008930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WTS, Inc
• Brenda Tran Wu
• Richard Wu
• Ziqi Wu, PHD
• Robert C Wunderle III, D.M.D.
• Katherine A Wurst, DC
• John R Wyant, MD
• Brittany Nicole Wyatt, LPC
• Therese K Wyatt, LAPC
• Charles W Wyble Jr., MD

• Oral and Maxillofacial Surgery (Dentist) in Marietta, GA
• Providers in Marietta, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.