Individual provider Active NPI

Stephanie L Wetzel, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Alpharetta, GA
National Provider Identifier
1528217940
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
DN015296 Issued in GA
Practice address
282 Rucker Rd Ste 110
Alpharetta, GA 30004-5826
Phone
(770) 992-4844
Fax
(770) 641-1511
NPI assigned
Sep 10, 2008
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X DN015296 GA Primary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 11045 KY
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X DN015296 GA

Addresses

Primary practice location

282 Rucker Rd Ste 110
Alpharetta, GA 30004-5826

Mailing address

290 Big Run Rd
Lexington, KY 40503-2903

Other practice location 1

290 Big Run Rd
Lexington, KY 40503-2903
Phone (859) 278-9513

Other identifiers 2

IdentifierTypeStateIssuer
003184098BMedicaidGA
7100943890MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150417001542 MN Practitioner - Oral SurgeryPractitioner - Pathology 7315265543
I20231113002561 KY Practitioner - DentistPractitioner - Pathology 7315265543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Pathology
Education
University of Minnesota School of Dentistry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chipps, Caffrey and Dubilier, P.S.CGroup PAC ID 4688573900, 19 clinicians

Practice addresses (Care Compare)

290 Big Run Rd
Lexington, KY 40503-2903
Phone (859) 278-9513

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
75
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11045KYMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Oral Diagnostics LLC Oral and Maxillofacial Pathology CurrentSince Jun 13, 2026 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients
Chipps, Caffrey & Dubilier, P.S.C CurrentSince Dec 1, 2023 Accepting new patients
Regents of the University of Minnesota CurrentSince Oct 1, 2014 Accepting new patients
Regents of the University of Minnesota CurrentSince Oct 1, 2014 Accepting new patients
Regents of the University of Minnesota Current Accepting new patients
Emory Specialty Associates, LLC Past Accepting new patients
Eastside Pathology PC Past Accepting new patients

Locations

282 Rucker Rd
Ste 110
Alpharetta, GA 30004
Phone (770) 992-4844

550 Pharr Rd NE
Ste 325
Atlanta, GA 30305
Phone (404) 233-8221

290 Big Run Rd
Lexington, KY 40503
Phone (859) 685-0600

420 Delaware St SE
Ste MMC83
Minneapolis, MN 55455

515 Delaware St SE
Ste 7-521
Minneapolis, MN 55455

Interoperability endpoints

  • Direct secure messaging: swetzel28209@direct.emory.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1528217940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 BIG RUN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 RUCKER RD STE 110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300045826",
            "telephone_number": "770-992-4844",
            "fax_number": "770-641-1511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 Big Run Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405032903",
            "country_code": "US",
            "telephone_number": "859-278-9513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "GA",
            "license": "DN015296",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "KY",
            "license": "11045",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "GA",
            "license": "DN015296",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003184098B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100943890",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.