Individual provider Active NPI

Jeremy P Wehrman, DDS

  • Dentist
  • Fargo, ND
National Provider Identifier
1295804334
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1959 Issued in ND
Practice address
306 4TH St N
Fargo, ND 58102-4820
Phone
(701) 239-7111
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1959 ND Primary
Dentist 122300000X 11940 MN

Addresses

Primary practice location

306 4TH St N
Fargo, ND 58102-4820

Mailing address

PO Box 2625
Fargo, ND 58108-2625
Phone (701) 239-7111

Other identifiers 1

IdentifierTypeStateIssuer
41338MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 15, 2021 through Feb 15, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1959NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Care Center Past Accepting new patients
University of North Dakota Past Accepting new patients

Organizations & group practices 2

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295804334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2625",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581082625",
            "telephone_number": "701-239-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 4TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024820",
            "telephone_number": "701-239-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHRMAN",
        "first_name": "JEREMY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "1959",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "11940",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41338",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.