Active NPI
Samuel Paul Wise, DDS
- Dentist
- North Canton, OH
National Provider Identifier
1417934100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 21951
- Practice address
- 6529 Frank Ave NW
North Canton, OH 44720-7265 - Phone
- (330) 433-1000
- NPI assigned
- Dec 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 21951 | OH | Primary |
Addresses
Primary practice location
6529 Frank Ave NW
North Canton, OH 44720-7265
Mailing address
9163 Hunters Chase St NW
Massillon, OH 44646-9560
Phone (614) 208-1984
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21951 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1417934100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9163 HUNTERS CHASE ST NW",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446469560",
"telephone_number": "614-208-1984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6529 FRANK AVE NW",
"city": "NORTH CANTON",
"state": "OH",
"postal_code": "447207265",
"telephone_number": "330-433-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "SAMUEL",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-23",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "21951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.