Bryan L. Wierwill, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

502001G Issued in WI

Practice address

5601 Odana Rd
Madison, WI 53719-1207

Phone

(608) 274-9077

Fax

(608) 274-9103

NPI assigned

Dec 6, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Affiliated Dentist SC

  • General Practice Dentistry
  • Madison, WI
  • NPI 1477663045
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1356400584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191207",
            "telephone_number": "608-274-9077",
            "fax_number": "608-274-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191207",
            "telephone_number": "608-274-9077",
            "fax_number": "608-274-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERWILL",
        "first_name": "BRYAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "502001G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "391362618",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quade R Wiegel, PA-C
• Aaron Michael Wieland, MD
• Shannon Christine Wieland, M.D., PH.D.
• Alyssa Ayumi Wiener, MD
• Emily Wiersma, LCSW
• Cayden Donald Wiese, RDN
• Emily Wiese
• Michele Mae Wiese, APNP
• Taylor Wiese
• Mary E Wiesen, NP

• General Practice Dentistry in Madison, WI
• Providers in Madison, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.