Wikle Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9575 Issued in OR

Legal business name

WIKLE DENTISTRY LLC

Doing business as

Wikle Family Dental

Practice address

3900 Douglas Way
Lake Oswego, OR 97035-3446

Phone

(503) 636-8446

Fax

(503) 636-4446

NPI assigned

Nov 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Aaron Wikle, D.M.D.

Title

Registered Agent/Member/Manager

Phone

(503) 726-8295

Specialties & licenses 1

Addresses

Other names 1

• Wikle Family Dental Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy John Edvalson, D.M.D.

  • General Practice Dentistry
  • Lake Oswego, OR
  • NPI 1205821154
  NPD (past)
• Carly Christoferson Petersen, DMD

  • General Practice Dentistry
  • Lake Oswego, OR
  • NPI 1841844354
  NPD (past)

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1174997142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 DOUGLAS WAY",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353446",
            "telephone_number": "503-636-8446",
            "fax_number": "503-636-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 DOUGLAS WAY",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353446",
            "telephone_number": "503-636-8446",
            "fax_number": "503-636-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIKLE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "WIKLE",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "REGISTERED AGENT/MEMBER/MANAGER",
        "authorized_official_telephone_number": "503-726-8295",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wikle Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Misty Dawn White, N.D.
• Rachel Diane White, MSW
• Whitney Black MD LLC
• Whole Systems Healthcare Lake Oswego Clinic
• Carrie Widman, PHARMD
• Katrina Wilhelm, N.D.
• Amy N Wilken
• Denise Marie Wilkinson, MSPT
• Meaghan Wilkinson
• Joel Benjamin Williams, PT

• General Practice Dentistry in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.