Wellpoint Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DH-1189 Issued in ID

Legal business name

WELLPOINT DENTAL

Practice address

2700 W Cherry LN
Meridian, ID 83642-1137

Phone

(208) 887-9000

NPI assigned

Jul 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Warren R Willis, DMD

Title

Co-Owner

Phone

(208) 887-9000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1194980417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421137",
            "telephone_number": "208-887-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421137",
            "telephone_number": "208-887-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLPOINT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "208-887-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "DH-1189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory W Welch
• Jacob Jay Welch, MD
• Garrett Weldon, DPT
• Timothy A Welebir, MD
• Wellness Grove Chiropractic, PLLC
• Wells & Bell LLC
• Becky J Wells, PAC
• Gregory L Wells, M.D.
• Ryan Michael Wells, PHARM.D., M.D.
• Jessica Louise Wenzel, MD, MPH

• General Practice Dentistry in Meridian, ID
• Providers in Meridian, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.