Individual provider Active NPI

Katherine Wezmar Poepperling, DMD

  • Pediatric Dentistry
  • Wilkes Barre, PA
National Provider Identifier
1386799153
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS036324 Issued in PA
Practice address
900 Schechter Drive
Wilkes Barre, PA 18702
Phone
(570) 822-4181
Fax
(570) 208-4984
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS036324 PA Primary

Addresses

Primary practice location

900 Schechter Drive
Wilkes Barre, PA 18702

Mailing address

900 Schechter Drive
Wilkes Barre, PA 18702
Phone (570) 822-4181

Other names 1

  • Katherine Maureen Wezmar Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS036324PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Ross Wezmar DDS PC Past Accepting new patients
S4K Wilkes-Barre, LLC Pediatric Dentistry PastSince Oct 17, 2021 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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1386799153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SCHECHTER DRIVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-822-4181",
            "fax_number": "570-208-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SCHECHTER DRIVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-822-4181",
            "fax_number": "570-208-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POEPPERLING",
        "first_name": "KATHERINE",
        "middle_name": "WEZMAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS036324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "WEZMAR",
            "middle_name": "MAUREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.