Michael R. Wendelboe, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5569 Issued in NV

Practice address

7260 W Azure Dr Ste 110
Las Vegas, NV 89130-4400

Phone

(702) 821-1688

Fax

(702) 636-1688

NPI assigned

Aug 13, 2007

Last updated

Dec 30, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• MW Dental Prof. LLC

  • Dental Clinic/Center
  • Las Vegas, NV
  • NPI 1962223784
  NPD Authorized official

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1689866766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 W AZURE DR STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7260 W AZURE DR STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304400",
            "telephone_number": "702-821-1688",
            "fax_number": "702-636-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDELBOE",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiaohong Wen
• Xiuxing Wen
• Margaret Wenberg, CCC-SLP
• Gerardo Wence-Munoz, PHD, MA
• Kristen M Wendelboe, PHARMD
• Douglas Ray Wendelin Jr.
• Jillian Marie Wendelin, LMFT
• Rayshawn Wendelin
• Markos Wenderfial
• Brittney Wendlandt

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.