Individual provider Active NPI

Abigail Michele Wieland

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • East Moline, IL
National Provider Identifier
1639809262
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
019035637 Issued in IL
Practice address
3800 Archer Dr
East Moline, IL 61244-3757
Phone
(309) 751-3080
NPI assigned
Jun 15, 2022
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-10004 IA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019035637 IL Primary

Addresses

Primary practice location

3800 Archer Dr
East Moline, IL 61244-3757

Mailing address

3800 Archer Dr
East Moline, IL 61244-3757
Phone (309) 751-3080

Other practice location 1

3475 Jersey Ridge Rd
Davenport, IA 52807-2293
Phone (563) 359-5510

Other practice location 2

801 Newton Rd
Iowa City, IA 52242-1001
Phone (319) 335-7440

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

LicenseStateTypeSpecialty
D-10004IAMDGeneral Practice Dentistry
019035637ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wieland Orthodontics, PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Jul 13, 2025 Accepting new patients

Locations

3800 Archer Dr
East Moline, IL 61244
Phone (309) 721-2451

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1639809262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 ARCHER DR",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612443757",
            "telephone_number": "309-751-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 ARCHER DR",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612443757",
            "telephone_number": "309-751-3080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3475 Jersey Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528072293",
            "country_code": "US",
            "telephone_number": "563-359-5510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Newton Rd",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421001",
            "country_code": "US",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIELAND",
        "first_name": "ABIGAIL",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "D-10004",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019035637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.