Active NPI
Ronald A Wihlidal, DDS
- Dentist
- Stockton, CA
National Provider Identifier
1154314995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24620
- Practice address
- 1616 N Harrison St
Ste C
Stockton, CA 95204-5642 - Phone
- (209) 466-9661
- Fax
- (209) 466-9664
- NPI assigned
- Aug 26, 2005
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 24620 | CA | Primary |
Addresses
Primary practice location
1616 N Harrison St
Ste C
Stockton, CA 95204-5642
Mailing address
1616 N Harrison St
Ste C
Stockton, CA 95204-5642
Phone (209) 466-9661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 15, 2015 through Dec 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24620 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1154314995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 N HARRISON ST",
"address_2": "STE C",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045642",
"telephone_number": "209-466-9661",
"fax_number": "209-466-9664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 N HARRISON ST",
"address_2": "STE C",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045642",
"telephone_number": "209-466-9661",
"fax_number": "209-466-9664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIHLIDAL",
"first_name": "RONALD",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "24620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.