Charles Adam Wisniewski, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS024093L Issued in PA

Practice address

722 Huntingdon Pike
Jenkintown, PA 19046-4461

Phone

(215) 379-2060

Fax

(215) 379-0386

NPI assigned

Jun 3, 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

Medicare fee-for-service enrollment

Enrolled in PA

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

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1427096106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 HUNTINGDON PIKE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190464461",
            "telephone_number": "215-379-2060",
            "fax_number": "215-379-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 HUNTINGDON PIKE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190464461",
            "telephone_number": "215-379-2060",
            "fax_number": "215-379-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "CHARLES",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024093L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Wiggon
• Aleksandra Wilkowski, COTA/L
• Hannah C Williams
• Jovan Marcel Wimberg
• Carolyn M Wise, CMT
• Women's Wellness of Abington
• Won Hee Kim MD
• Twana Wood, SW
• Mary Virginia Woods, CPNP
• Wound and Education Consultants LLC

• General Practice Dentistry in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.