Douglas Kyle Wissler, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2018022475 Issued in MO

Practice address

7313 Watson Rd
Saint Louis, MO 63119-4405

Phone

(314) 352-3886

NPI assigned

Jun 27, 2018

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 MO

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.

• Ronald R Mainhurst DMD PC

  • General Practice Dentistry
  • Saint Louis, MO
  • NPI 1437323888
  NPD (past)

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1417442930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 SPROULE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631393107",
            "telephone_number": "309-706-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7313 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194405",
            "telephone_number": "314-352-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSLER",
        "first_name": "DOUGLAS",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2018022475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wishing Well Counseling, LLC
• Jamieson A Wishman, CRNA
• Madeleine Wisler, MS
• Theresa Flora Wiss, LCSW
• Katherine Grace Wissing
• Bradley Carl Witbrodt, M.D.
• With Every Breath Doula Services LLC
• With Kare CDS Services LLC
• With Love Health Services, LLC
• With Love in-Home Care LLC

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.