Active NPI
Steven E Wells, DMD
- General Practice Dentistry
- Winder, GA
National Provider Identifier
1104027713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN013528
- Practice address
- 48 Piedmont Dr
Suite 302
Winder, GA 30680-8131 - Phone
- (770) 868-8788
- Fax
- (770) 868-8781
- NPI assigned
- May 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN013528 | GA | Primary |
Addresses
Primary practice location
48 Piedmont Dr
Suite 302
Winder, GA 30680-8131
Mailing address
1612 Mount Vernon Forest CT
Dunwoody, GA 30338-4607
Phone (770) 868-8788
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221201002184 | GA | Order and Referring Only - Dentist | 7618345257 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104027713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1612 MOUNT VERNON FOREST CT",
"city": "DUNWOODY",
"state": "GA",
"postal_code": "303384607",
"telephone_number": "770-868-8788",
"fax_number": "770-868-8781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 PIEDMONT DR",
"address_2": "SUITE 302",
"city": "WINDER",
"state": "GA",
"postal_code": "306808131",
"telephone_number": "770-868-8788",
"fax_number": "770-868-8781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "STEVEN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN013528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winder, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.