Individual provider Active NPI

William Wiering, DDS

  • General Practice Dentistry
  • Hastings, MI
National Provider Identifier
1205455490
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901601789 Issued in MI
Practice address
200 S Boltwood St
Hastings, MI 49058-1926
Phone
(269) 945-4220
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 00204338 CO
General Practice Dentistry 1223G0001X 00204338 CO
General Practice Dentistry 1223G0001X 2901601789 MI Primary

Addresses

Primary practice location

200 S Boltwood St
Hastings, MI 49058-1926

Mailing address

200 S Boltwood St
Hastings, MI 49058-1926
Phone (269) 945-4220

Other practice location 1

354 Blue River Pkwy
Silverthorne, CO 80498
Phone (970) 262-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20241113003322 MI Order and Referring Only - DentistPractitioner - Dentist 4082148077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00204338COMDDentist
2901601789MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Comfort Smiles Prof LLC PastSince Nov 1, 2020 Accepting new patients
Silverthorne Dental Partners Prof LLP General Practice PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1205455490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S BOLTWOOD ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581926",
            "telephone_number": "269-945-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S BOLTWOOD ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581926",
            "telephone_number": "269-945-4220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Blue River Pkwy",
            "address_purpose": "LOCATION",
            "city": "Silverthorne",
            "state": "CO",
            "postal_code": "80498",
            "country_code": "US",
            "telephone_number": "970-262-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIERING",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00204338",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00204338",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MI

Sources for this page

Verify at the official NPI Registry.