Organization Active NPI

Wiesemann Orthodontics Inc. PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bowling Green, KY
National Provider Identifier
1740574458
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
8503 Issued in TN
Legal business name
WIESEMANN ORTHODONTICS INC. PC
Practice address
894 Fred Lively Rd
Bowling Green, KY 42104-7424
Phone
(616) 325-4677
NPI assigned
May 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

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

Authorized official

Name
Dr. Ryan B. Wiesemann, DMD,MS
Title
Orthodontists/Owner
Phone
(615) 325-4677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 8503 TN Primary

Addresses

Primary practice location

894 Fred Lively Rd
Bowling Green, KY 42104-7424

Mailing address

323 West Dr
White House, TN 37188-9294
Phone (615) 325-4677

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1740574458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 WEST DR",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371889294",
            "telephone_number": "615-325-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 FRED LIVELY RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421047424",
            "telephone_number": "616-325-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIESEMANN ORTHODONTICS INC. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "WIESEMANN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "ORTHODONTISTS/OWNER",
        "authorized_official_telephone_number": "615-325-4677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD,MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "8503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.