Kristin Tera Wiseman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8312 Issued in NC

Practice address

9920 Couloak Dr
#100
Charlotte, NC 28216-8925

Phone

(704) 392-7676

NPI assigned

Nov 8, 2006

Last updated

Jul 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1285704171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 COULOAK DR",
            "address_2": "#100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168925",
            "telephone_number": "704-392-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 COULOAK DR",
            "address_2": "#100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168925",
            "telephone_number": "704-392-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "KRISTIN",
        "middle_name": "TERA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8312",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayci Raye Wise
• Khysha Le Wise, CSAC
• Leah Wise, MS, LAT, ATC
• Michelle Wise
• Valarie Wise
• Mary Ragan Wiseman
• Ryan Wishart, LMFT, LCAS
• Joel A Wissing, M.D.
• Wisteria Counseling and Consulting
• Hannah Witcher

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.