Jeremy Wilde, D.M.D., M.S.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

30.023002 Issued in OH

Practice address

26300 Euclid Ave Ste 620
Euclid, OH 44132-3703

Phone

(216) 261-6464

NPI assigned

Apr 29, 2009

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 OH

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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1104060540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26300 EUCLID AVE STE 620",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441323703",
            "telephone_number": "216-261-6464",
            "fax_number": "216-261-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26300 EUCLID AVE STE 620",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441323703",
            "telephone_number": "216-261-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.023002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jedda Whitfield
• Tomaniqua Whitner
• Andrea Whittiker
• Carla Widener
• Whitney Wilcoxson, LSW
• Keosha Lynetta Wiley
• Sylvia Wiliams
• Wilkes Care Living Co.
• Eric Linnell Wilkes Jr.
• Deanna K Willett, LPN

• Endodontics in Euclid, OH
• Providers in Euclid, OH by specialty
• Endodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.