Individual provider Active NPI

David N. Wells, D.M.D.

  • Dentist
  • Mount Vernon, IN
National Provider Identifier
1760891618
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012203A Issued in IN
Practice address
803 East Fourth Street
Mount Vernon, IN 47620-0673
Phone
(812) 838-4841
Fax
(812) 838-4844
NPI assigned
Aug 5, 2014
Last updated
Aug 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012203A IN Primary
Dentist 122300000X 019029853 IL

Addresses

Primary practice location

803 East Fourth Street
Mount Vernon, IN 47620-0673

Mailing address

PO Box 673
803 East Fourth Street
Mount Vernon, IN 47620-0673
Phone (812) 838-4841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20150604002562 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587985379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012203AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1760891618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673",
            "address_2": "803 EAST FOURTH STREET",
            "city": "MOUNT VERNON",
            "state": "IN",
            "postal_code": "476200673",
            "telephone_number": "812-838-4841",
            "fax_number": "812-838-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 EAST FOURTH STREET",
            "city": "MOUNT VERNON",
            "state": "IN",
            "postal_code": "476200673",
            "telephone_number": "812-838-4841",
            "fax_number": "812-838-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "DAVID",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012203A",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029853",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IN

Sources for this page

Verify at the official NPI Registry.