Individual provider Active NPI

Robert W Wheeler, DDS

  • General Practice Dentistry
  • La Canada, CA
National Provider Identifier
1184740805
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40322 Issued in CA
Practice address
1346 Foothill Blvd Ste 302
La Canada, CA 91011-2152
Phone
(818) 790-1710
Fax
(818) 790-1561
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40322 CA Primary

Addresses

Primary practice location

1346 Foothill Blvd Ste 302
La Canada, CA 91011-2152

Mailing address

1346 Foothill Blvd Ste 302
La Canada, CA 91011-2152
Phone (818) 790-1710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20140812000298 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0648497891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184740805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 FOOTHILL BLVD STE 302",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910112152",
            "telephone_number": "818-790-1710",
            "fax_number": "818-790-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 FOOTHILL BLVD STE 302",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910112152",
            "telephone_number": "818-790-1710",
            "fax_number": "818-790-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada, CA

Sources for this page

Verify at the official NPI Registry.