John R. Wiens, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D11255 Issued in OR

Practice address

1030 29TH Ave SW
Albany, OR 97321-3416

Phone

(541) 924-1190

NPI assigned

Jul 11, 2013

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

Enrolled in CA

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

Practice roles

Locations

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.

• Ross Mitchell DMD

  • Endodontics
  • Albany, OR
  • NPI 1053959585
  NPD
• Glen S Gerdes DMD PC

  • Endodontics
  • Corvallis, OR
  • NPI 1295951929
  NPD (past)
• Ross P. Mitchell D.M.D., LLC

  • Endodontics
  • Albany, OR
  • NPI 1194010660
  NPD (past)

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1114368776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973210116",
            "telephone_number": "559-906-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 29TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973213416",
            "telephone_number": "541-924-1190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 NW Kings Blvd",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973301907",
            "country_code": "US",
            "telephone_number": "541-758-0888",
            "fax_number": "541-754-6628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIENS",
        "first_name": "JOHN",
        "middle_name": "R.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62455",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D11255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Daniel White, DMD
• Heather Whitfield
• Meghan Whitt, D.O.
• Jason Whitton, PHARMD
• Sara Kathryn Whyte, MD, MPH
• Dana B Wikner
• Shaun P Wilcox, LMT
• Tiffany Wilcox, RN
• Joslynn Wilder
• David Wilkinson, LMT, CMT

• Endodontics in Albany, OR
• Providers in Albany, OR by specialty
• Endodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.