Individual provider Active NPI

Karl G Wiese, DDS

  • Dentist
  • Orlando, FL
National Provider Identifier
1437721164
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26231 Issued in FL
Practice address
9436 Narcoossee Rd
Orlando, FL 32827-5705
Phone
(321) 300-2235
Fax
(321) 290-1545
NPI assigned
Jul 13, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN26231 FL Primary

Addresses

Primary practice location

9436 Narcoossee Rd
Orlando, FL 32827-5705

Mailing address

9436 Narcoossee Rd
Orlando, FL 32827-5705
Phone (321) 300-2235

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Orlando Direct

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
DN26231FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1437721164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9436 NARCOOSSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328275705",
            "telephone_number": "321-300-2235",
            "fax_number": "321-290-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9436 NARCOOSSEE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328275705",
            "telephone_number": "321-300-2235",
            "fax_number": "321-290-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "KARL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-13",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Orlando",
            "affiliation": "N",
            "endpointDescription": "Orlando",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Orlando,Florida",
            "address_1": "9436 Narcoossee Rd",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328275705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.