Individual provider Active NPI

Wyley Wondercheck, D.D.S.

  • General Practice Dentistry
  • Norfolk, NE
National Provider Identifier
1295116382
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7236 Issued in NE
Practice address
513 S. 13TH St.
Norfolk, NE 68701
Phone
(402) 379-2775
NPI assigned
Jun 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7236 NE Primary

Addresses

Primary practice location

513 S. 13TH St.
Norfolk, NE 68701

Mailing address

513 S 13TH St
Norfolk, NE 68701-4966
Phone (402) 379-2775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20160414001264 NE Order and Referring Only - DentistPractitioner - Dentist 5294033866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Dental Associates of Nebraska, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1295116382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 S 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014966",
            "telephone_number": "402-379-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S. 13TH ST.",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "68701",
            "telephone_number": "402-379-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONDERCHECK",
        "first_name": "WYLEY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

Verify at the official NPI Registry.