Active NPI
Gary Alan Wolanek, DMD
- Endodontics
- Auburn, AL
National Provider Identifier
1497945570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 4414
- Practice address
- 999 Drew LN
Auburn, AL 36830-4301 - Phone
- (334) 821-6817
- Fax
- (334) 821-6884
- NPI assigned
- Jul 26, 2007
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 4414 | AL | Primary |
Addresses
Primary practice location
999 Drew LN
Auburn, AL 36830-4301
Mailing address
999 Drew LN
Auburn, AL 36830-4301
Phone (334) 821-6817
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 7, 2016 through Apr 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4414 | AL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1497945570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "999 DREW LN",
"city": "AUBURN",
"state": "AL",
"postal_code": "368304301",
"telephone_number": "334-821-6817",
"fax_number": "334-821-6884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 DREW LN",
"city": "AUBURN",
"state": "AL",
"postal_code": "368304301",
"telephone_number": "334-821-6817",
"fax_number": "334-821-6884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLANEK",
"first_name": "GARY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-26",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "AL",
"license": "4414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.