Bruce B Wiland, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12008945 Issued in IN

Practice address

5162 E Stop 11 Rd
Suite 2
Indianapolis, IN 46237-8617

Phone

(317) 888-3322

Fax

(317) 888-8325

NPI assigned

Jun 17, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 19, 2015 through Oct 19, 2027

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 and National Provider Directory roles.

• Bruce B. Wiland, DDS, MSD

  • Periodontics
  • Kokomo, IN
  • NPI 1366697070
  NPD (past) Authorized official

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1740225556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5162 E STOP 11 RD",
            "address_2": "SUITE 2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378617",
            "telephone_number": "317-888-3322",
            "fax_number": "317-888-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5162 E STOP 11 RD",
            "address_2": "SUITE 2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378617",
            "telephone_number": "317-888-3322",
            "fax_number": "317-888-8325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2519 E Main St Ste 107",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IN",
            "postal_code": "473745869",
            "country_code": "US",
            "telephone_number": "866-988-3322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3415 S LaFountain St Ste K",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469023827",
            "country_code": "US",
            "telephone_number": "765-864-0700",
            "fax_number": "888-317-2691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILAND",
        "first_name": "BRUCE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12008945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhiannon Wiggs, RBT
• Deemantha Gayan Fernando Wijekulasooriyage, MD
• H R Sagara Wijeratne
• Neshahthari Wijeyakuhan, MD
• Kelly Nicole Wikse, PA-C
• Cherokee Wilbourn
• Beau Wilbrandt, DO
• Michelle Moss Wilbrandt, PMH-NP
• Thierry H Wilbrandt, M.D.
• Deanna Wilbur

• Periodontics in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Periodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.