Judith Carol Wheeler, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30.015942 Issued in OH

Practice address

915 W Main St
Kent, OH 44240-2217

Phone

(239) 298-2906

NPI assigned

Mar 23, 2011

Last updated

Sep 26, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1114226636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MAIN ST",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442402217",
            "telephone_number": "239-298-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W MAIN ST",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442402217",
            "telephone_number": "239-298-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JUDITH",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.015942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Western Reserve Professional Group Inc (Occ Med Source)
• Western Reserve Professional Group Inc (The Spine & Pain Institute)
• Allyson Westover, CDCA
• Jordyn Wheaton
• Alivia Wheeler
• Tammy Michele Wheeler
• Alison G. Whitaker
• Jasmine Lana'E White
• McLain M Whitney, ATC
• Jovawn Whitted

• Dentist in Kent, OH
• Providers in Kent, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.