Active NPI
Charles F Wetzel, DDS
- Dentist
- Elcho, WI
National Provider Identifier
1619978319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5001503015
- Practice address
- W10610 Clinic St
Elcho, WI 54428-9619 - Phone
- (715) 275-4484
- Fax
- (715) 275-4533
- NPI assigned
- Aug 3, 2005
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 5001503015 | WI | Primary |
Addresses
Primary practice location
W10610 Clinic St
Elcho, WI 54428-9619
Mailing address
PO Box 339
Elcho, WI 54428-0339
Phone (715) 275-4484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33547100 | Medicaid | WI |
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 |
|---|---|---|---|
| 5001503015 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1619978319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 339",
"city": "ELCHO",
"state": "WI",
"postal_code": "544280339",
"telephone_number": "715-275-4484",
"fax_number": "715-275-4533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W10610 CLINIC ST",
"city": "ELCHO",
"state": "WI",
"postal_code": "544289619",
"telephone_number": "715-275-4484",
"fax_number": "715-275-4533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETZEL",
"first_name": "CHARLES",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "5001503015",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33547100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elcho, WI
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.