Active NPI
Eugen Gustav Wichmann, D.M.D.
- General Practice Dentistry
- Plainville, CT
National Provider Identifier
1124087903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 008412
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150708000828 | CT | Order and Referring Only - Oral Surgery | 7214249002 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8412 | CT | MD | Clinical Social Worker |
| 008412 | CT | MD | Physical 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.