Individual provider Active NPI

Peter George Wolfram Jr., D.D.S.

  • Dentist
  • Toledo, OH
National Provider Identifier
1235318965
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19840 Issued in OH
Practice address
2138 Madison Ave
Toledo, OH 43604-5131
Phone
(419) 241-1644
NPI assigned
Oct 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19840 OH Primary

Addresses

Primary practice location

2138 Madison Ave
Toledo, OH 43604-5131

Mailing address

2138 Madison Ave
Toledo, OH 43604-5131
Phone (419) 241-1644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19840OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1235318965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045131",
            "telephone_number": "419-241-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045131",
            "telephone_number": "419-241-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFRAM",
        "first_name": "PETER",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "19840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.