Active NPI
Patrick Wendling, DMD
- General Practice Dentistry
- La Salle, IL
National Provider Identifier
1508412149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.032126
- Practice address
- 2424 Chartres St
La Salle, IL 61301-1107 - Phone
- (815) 223-6013
- NPI assigned
- Aug 9, 2019
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.032126 | IL | Primary |
Addresses
Primary practice location
2424 Chartres St
La Salle, IL 61301-1107
Mailing address
14613 S Stonegate Dr
Homer Glen, IL 60491-6783
Phone (630) 512-1115
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 |
|---|---|---|---|
| 019.032126 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565308800000",
"number": "1508412149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14613 S STONEGATE DR",
"city": "HOMER GLEN",
"state": "IL",
"postal_code": "604916783",
"telephone_number": "630-512-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 CHARTRES ST",
"city": "LA SALLE",
"state": "IL",
"postal_code": "613011107",
"telephone_number": "815-223-6013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENDLING",
"first_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-09",
"last_updated": "2019-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.032126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Salle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.