Christopher Wisniewski, D.D.S.
Individual provider Active NPI Dentist · Glover, VT
NPI 1295186104 · NPPES record last updated Sep 26, 2025
Key facts
- NPI
- 1295186104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 016.0121171 (VT)
- Practice address
- 3032 Glover St
Glover, VT 05839-9701 - Phone
- (800) 539-1127
- Fax
- (844) 444-1127
- NPI assigned
- Jun 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016.0121171 | VT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Street Dental, PLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 016.0121171 | VT | Yes |
Addresses
Primary practice location
3032 Glover St
Glover, VT 05839-9701
Mailing address
3032 Glover St
Glover, VT 05839-9701
Phone (800) 539-1127
Other providers in Glover, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.