Active NPI
John Wesley Vollenweider, DMD
- General Practice Dentistry
- Lagrange, GA
National Provider Identifier
1508868613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9011
- Practice address
- 210 N Lewis St
Lagrange, GA 30240-2738 - Phone
- (706) 882-2551
- Fax
- (706) 845-0469
- NPI assigned
- Jun 1, 2005
- 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 | 9011 | GA | Primary |
Addresses
Primary practice location
210 N Lewis St
Lagrange, GA 30240-2738
Mailing address
210 N Lewis St
Lagrange, GA 30240-2738
Phone (706) 882-2551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150424001415 | GA | Order and Referring Only - Other (Physician) | 3678892619 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9011 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508868613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 N LEWIS ST",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302402738",
"telephone_number": "706-882-2551",
"fax_number": "706-845-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N LEWIS ST",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302402738",
"telephone_number": "706-882-2551",
"fax_number": "706-845-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOLLENWEIDER",
"first_name": "JOHN",
"middle_name": "WESLEY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "9011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
- Meenakshi Vij, M.D.
- Minerva Villafane, MD
- Vision World Inc (professional opticians)
- Vision World Inc
- Vital Care Homecare Agency LLC
- Chelsea Waddell, RNC-OB
- M. Dianne Wages, LPC
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0614)
- Wal-Mart Stores East LP (Walmart Pharmacy 10-2773)
- Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.