John A Wilde, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

05824 Issued in IA

Practice address

1626 Morgan St
Suite 3
Keokuk, IA 52632

Phone

(319) 524-1477

Fax

(319) 524-7965

NPI assigned

Nov 6, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265501316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 MORGAN ST",
            "address_2": "SUITE 3",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "52632",
            "telephone_number": "319-524-1477",
            "fax_number": "319-524-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 MORGAN ST",
            "address_2": "SUITE 3",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "52632",
            "telephone_number": "319-524-1477",
            "fax_number": "319-524-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "05824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "38071",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1089326",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA DENTAL LICENSE",
            "identifier": "05824",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Weirather, FNP-C
• Tiffanie M West-Bennett, CADC
• Joseph P Whalen, OT
• Erin L Wheeler, FNP-BC
• Christa Wiggins, FNP-C
• Craig Harold Wills, R.PH.
• Dennis E. Wolter, D.C.
• Jennifer R Wong, PT
• Michael Woodring, R PH
• Ruth Ann Woolson

• General Practice Dentistry in Keokuk, IA
• Providers in Keokuk, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.