Individual provider Active NPI

Eugen Gustav Wichmann, D.M.D.

  • General Practice Dentistry
  • Plainville, CT
National Provider Identifier
1124087903
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008412 Issued in CT
Practice address
55 Whiting St
Ste 2C
Plainville, CT 06062-2262
Phone
(860) 747-5529
Fax
(860) 747-5520
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 008412 CT Primary

Addresses

Primary practice location

55 Whiting St
Ste 2C
Plainville, CT 06062-2262

Mailing address

55 Whiting St
Ste 2C
Plainville, CT 06062-2262
Phone (860) 747-5529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20150708000828 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214249002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8412CTMDClinical Social Worker
008412CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124087903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITING ST",
            "address_2": "STE 2C",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622262",
            "telephone_number": "860-747-5529",
            "fax_number": "860-747-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITING ST",
            "address_2": "STE 2C",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622262",
            "telephone_number": "860-747-5529",
            "fax_number": "860-747-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "EUGEN",
        "middle_name": "GUSTAV",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, CT

Sources for this page

Verify at the official NPI Registry.