Active NPI
John Hardie Wheelock, DDS
- Oral and Maxillofacial Surgery (Dentist)
- El Paso, TX
National Provider Identifier
1104453075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 42189
- Practice address
- 10175 Gateway Blvd W Ste 304
El Paso, TX 79925-2203 - Phone
- (915) 504-6880
- Fax
- (915) 599-8579
- NPI assigned
- Mar 23, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D011987 | AZ | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 42189 | TX | Primary |
Addresses
Primary practice location
10175 Gateway Blvd W Ste 304
El Paso, TX 79925-2203
Mailing address
10175 Gateway Blvd W Ste 304
El Paso, TX 79925-2203
Phone (915) 504-6880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- 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 |
|---|---|---|---|---|
| I20200707000841 | DE | Order and Referring Only - Dentist | 1658794854 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D011987 | AZ | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Dental Specialty PLLC | Current | Accepting new patients | |
| West Texas Maxillofacial Surgery PA | Single Specialty | Past | Accepting new patients |
Locations
15810 S 45th St
Ste 120
Phoenix, AZ 85048
Phone (480) 753-1300
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 and National Provider Directory roles.
-
- Endodontics
- Phoenix, AZ
- NPI 1871018887
-
- Oral & Maxillofacial Surgery (D.M.D.)
- El Paso, TX
- NPI 1700178555
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776297600000",
"number": "1104453075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10175 GATEWAY BLVD W STE 304",
"city": "EL PASO",
"state": "TX",
"postal_code": "799252203",
"telephone_number": "915-504-6880",
"fax_number": "915-599-8579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10175 GATEWAY BLVD W STE 304",
"city": "EL PASO",
"state": "TX",
"postal_code": "799252203",
"telephone_number": "915-504-6880",
"fax_number": "915-599-8579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELOCK",
"first_name": "JOHN",
"middle_name": "HARDIE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-23",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "AZ",
"license": "D011987",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TX",
"license": "42189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.