Michaela Rae Wiseman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38329 Issued in TX

Practice address

2040 FM 633
#420
Midlothian, TX 76065

Phone

(972) 528-4802

NPI assigned

Jun 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Dentists of Midlothian and Orthodontics PC

  • Dentist
  • Midlothian, TX
  • NPI 1437648110
  NPD (past)

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1740856780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 FM 663 STE 420",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760656571",
            "telephone_number": "317-908-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 FM 633",
            "address_2": "#420",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "76065",
            "telephone_number": "972-528-4802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871314516",
            "country_code": "US",
            "telephone_number": "505-720-2019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "MICHAELA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "TD-00-140",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carri Wilson
• Christopher Wilson, DC
• Jessica Wilson, B.S.N, R.N.
• Megan Winkler
• Winters Haven Counseling and Consulting, PLLC
• With Joy Care Services LLC
• Wound Pharm, PLLC
• Robert Wright, DC
• Jessica Wrinkle, M.S., CCC-SLP
• Cherice Lynn Wyckoff, SLP

• General Practice Dentistry in Midlothian, TX
• Providers in Midlothian, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.