Jongbin Wie, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN123098 Issued in GA

Practice address

1425 Riverstone Pkwy # 200
Canton, GA 30114-5611

Phone

(770) 479-0600

NPI assigned

Jul 18, 2023

Last updated

Jul 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canton Smiles Dentistry, PC

  dba Canton Smiles Dentistry

  • Dentist
  • Canton, GA
  • NPI 1093149486
  NPD (past)

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1164101945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 RIVERSTONE PKWY STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145611",
            "telephone_number": "954-952-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 RIVERSTONE PKWY # 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145611",
            "telephone_number": "770-479-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 Apple Blossom Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417782",
            "country_code": "US",
            "telephone_number": "954-952-2081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIE",
        "first_name": "JONGBIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Strickland White, RD
• Natalie Paris Whitehead, APC
• Ernest Lee Whitmarsh Jr., PH.D.
• Wickshire Canton Opco LLC
• Douglas B Widener, M.D.
• Gina Marie Wiedrich, MT
• Benjamin Russell Wiener, MD
• Memorie S Wilcoxon, PHARMD
• David Wilder, DMD
• Kevin F Wildes, LPTA,CSCS

• General Practice Dentistry in Canton, GA
• Providers in Canton, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.