David B. Wiley, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6828 Issued in OR

Practice address

2330 NW Flanders St Ste 204
Portland, OR 97210-3460

Phone

(503) 223-5040

Fax

(503) 222-3101

NPI assigned

Apr 24, 2007

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

Enrolled in OR

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

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 and National Provider Directory roles.

• Uptown Family Dental LLC

  • General Practice Dentistry
  • Portland, OR
  • NPI 1457103905
  NPD Authorized official
• Mike Moody LLC

  • Dental Clinic/Center
  • Portland, OR
  • NPI 1871310284
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295954717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 NW FLANDERS ST STE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103460",
            "telephone_number": "503-223-5040",
            "fax_number": "503-222-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 NW FLANDERS ST STE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103460",
            "telephone_number": "503-223-5040",
            "fax_number": "503-222-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "DAVID",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wildwood Healing LLC
• Wildwood Reconnections LLC
• Andrew Wildwood, LAC
• Sarah Arlee Wildwood, LPCA
• Robert Michael Wilechansky, M.D.
• Jenna Marie Wiley, MD
• Keri Wiley, CADC-R, QMHA-R
• Bethany Rae Wilhelm, LCSW, CADC II
• Jennifer Wilhelm, PT
• Jennifer Susan Wilhelm, D.C.

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.