Jeffery Bryan Wheaton, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS 2052 Issued in NM

Practice address

1628 Alameda Blvd NW
Albuquerque, NM 87114

Phone

(505) 899-6979

Fax

(505) 899-6980

NPI assigned

Aug 18, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 10, 2011 through Aug 10, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104930288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87114",
            "telephone_number": "505-899-6979",
            "fax_number": "505-899-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87114",
            "telephone_number": "505-899-6979",
            "fax_number": "505-899-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATON",
        "first_name": "JEFFERY",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "DDS    MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NM",
            "license": "DDS 2052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G5543",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Wharton
• Addyson Whatley
• Ginger Whatley, MS, LPC, LCDC
• Kevin Whatley, TECHNICIAN
• Zoe Whatley
• Jennifer L Wheeler Buenger, M.D.
• Devin Darby Wheeler, MA
• Jeannie Wheeler
• Margueritte Wheeler
• Megan Wheeler

• Oral and Maxillofacial Surgery (Dentist) in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Mexico

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.