Justin Tiedge, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6439-12 Issued in WI

Practice address

122 Green Bay Rd
Thiensville, WI 53092-1624

Phone

(262) 478-9104

NPI assigned

Oct 29, 2026

Last updated

Oct 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1793232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793232000000",
    "number": "1295633113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 VOGT DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958508",
            "telephone_number": "262-478-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 GREEN BAY RD",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530921624",
            "telephone_number": "262-478-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDGE",
        "first_name": "JUSTIN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-29",
        "last_updated": "2026-10-29",
        "certification_date": "2026-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6439-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Tepp, DPT
• Thiensville Family Health Care SC
• Thurow Primary Preventive Healthcare, SC
• Sharon K Thurow, APNP
• David Bruce Tick, M.D.
• Todd Tischer, RPH
• US Healthcenter, Inc.
• Via Therapy LLC
• Village of Thiensville (Village of Thiensville Fire Dept)
• Walgreen Co (Walgreens #04884)

• Chiropractor in Thiensville, WI
• Providers in Thiensville, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2026; 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.