Wisdom Family Dentistry, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5188A Issued in KS

Legal business name

WISDOM FAMILY DENTISTRY, P.A.

Practice address

712 6TH St
Clay Center, KS 67432-2915

Phone

(785) 632-2400

Fax

(785) 632-5893

NPI assigned

Jul 15, 2006

Last updated

Jan 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric J Wisdom, DDS

Title

Owner

Phone

(785) 632-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1487670089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 6TH ST",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674322915",
            "telephone_number": "785-632-2400",
            "fax_number": "785-632-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 6TH ST",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674322915",
            "telephone_number": "785-632-2400",
            "fax_number": "785-632-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM FAMILY DENTISTRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-632-2400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5188A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100095990B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Clay Center, KS
• Providers in Clay Center, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.