Jeffrey David Wegener, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

8703919-9922 Issued in UT

Practice address

1451 N 200 E Ste 200
Logan, UT 84341-7565

Phone

(435) 753-4400

Fax

(435) 753-5599

NPI assigned

Jun 26, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1417211350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 N 200 E STE 200",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417565",
            "telephone_number": "435-753-4400",
            "fax_number": "435-753-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 N 200 E STE 200",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417565",
            "telephone_number": "435-753-4400",
            "fax_number": "435-753-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGENER",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "8703919-9922",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "4140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Weathers, M.D.
• Nancy B. Webb, RN, MS
• Elaine Margaret Weber, RN
• Samuel Weber, M.D.
• Marissa Weeks, PA
• Kenneth George Weigand, PSY D
• Bartley M Weiss, MD
• Matthew John Welter, M.D.
• Kristin Michelle West, ATC-L
• Western Intermountain Lithotripsy

• Dentist in Logan, UT
• Providers in Logan, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.