Lauren Wiese

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

026532 Issued in NJ

Practice address

957 Route 33
Hamilton Square, NJ 08690

Phone

(609) 587-5858

NPI assigned

Aug 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1144776543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ACORN HILL HOLW",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431524",
            "telephone_number": "609-841-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 ROUTE 33",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "08690",
            "telephone_number": "609-587-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Lombard St Apt 1016",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212012537",
            "country_code": "US",
            "telephone_number": "609-841-8121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Acorn Hill Holw",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080431524",
            "country_code": "US",
            "telephone_number": "609-841-8121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESE",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "16148",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "12451",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "026532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul F Varnis, DDS
• Massimo Vincenzo Verduci, DMD
• Vincent M. Immordino, DMD, PA
• Yue Wang, M.D.
• Sidney Whitman, DDS
• Wigful Thinking
• Svetlana Zabludovsky, CRNA
• Annette E Zwick, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Hamilton Square, NJ
• Providers in Hamilton Square, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2019; 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.