Jeffrey Kent Wichmann, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12069 Issued in MN

Practice address

7373 147TH St. W. #116
Apple Valley, MN 55124

Phone

(952) 432-8110

Fax

(952) 432-4457

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Practice roles

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

• Valley Oaks Dental

  • General Practice Dentistry
  • Apple Valley, MN
  • NPI 1417101601
  NPD (past) Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1184712838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 GRANADA DR",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247419",
            "telephone_number": "952-432-8110",
            "fax_number": "952-432-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 147TH ST. W. #116",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "55124",
            "telephone_number": "952-432-8110",
            "fax_number": "952-432-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "JEFFREY",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12069",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "12069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick J Wellik, O.D.
• Rachel Ann Werner
• Rachel Lynne West, LPN
• Adrianne Denise Westmoreland, DO
• Christopher Whitney, D.C.
• David Russell Widdifield, M.D.
• Willa Healthcare LLC
• Kelly Willems
• Lillian Kay Willett
• Aaron Williams, D.C.

• General Practice Dentistry in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; 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.