Kelly B Wettstein, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6572 Issued in AZ

Practice address

5970 S. Cooper Rd
Suite #1
Chandler, AZ 85249

Phone

(480) 814-8888

Fax

(480) 814-1553

NPI assigned

Sep 14, 2006

Last updated

Jan 15, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Casa Grande Impressions II, LLC

  dba Impressions Dental

  • General Practice Dentistry
  • Casa Grande, AZ
  • NPI 1851521918
  Authorized official Same address or phone
• Impressions Dental

  • General Practice Dentistry
  • Chandler, AZ
  • NPI 1033398870
  Authorized official Same address or phone
• HDP Affinity Dental LLC

  dba Affinity Dental

  • General Practice Dentistry
  • Queen Creek, AZ
  • NPI 1760036644
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1285739078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD",
            "address_2": "STE 130",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425995",
            "telephone_number": "480-249-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 S. COOPER RD",
            "address_2": "SUITE #1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85249",
            "telephone_number": "480-814-8888",
            "fax_number": "480-814-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTSTEIN",
        "first_name": "KELLY",
        "middle_name": "B",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D6572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Western Med Group LLC
• Yvette Westervelt
• Savannah Westfall
• Weston Rehabilitation Arizona LLC (Emeritus at Chandler)
• Sarah Jo Westrick
• Janelle L Weyer, MD
• Carrie Lynn Weyrauch, OTD
• Amanda Kristin Whaley, NMD
• Chandra Yeoman Whaley, M.S, CCC-SLP
• Sarah Gaylene Whaley, PHARMD

• General Practice Dentistry in Chandler, AZ
• Providers in Chandler, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.