Thomas Wiese, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

10712 S Ewing Ave
Chicago, IL 60617-6626

Phone

(773) 734-6679

NPI assigned

Mar 9, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1205020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205020800000",
    "number": "1114197886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10712 S EWING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176626",
            "telephone_number": "773-734-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10712 S EWING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176626",
            "telephone_number": "773-734-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-09",
        "last_updated": "2008-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Wierzbicki, LPC
• Thomas Wierzbinski, BCBA
• Holly Noelle Wiese, A.M., MSW, LCSW
• Lisa Jane Wiese, LCSW
• Michelle Louise Wiese
• William C Wiese, LSW
• Braedon Francis Wieseler, PA-C
• Rebecca Wiesenthal, MSW,LSW
• Wiesman Hand Surgery LLC
• Gary G Wiesman, MD

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.