John L. Wiles, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010080 Issued in IN

Practice address

200 Conrad Harcourt Way
Rushville, IN 46173-1100

Phone

(765) 932-5533

Fax

(765) 932-4569

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in IN

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

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780779173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10270 N. FIVE POINTS ROAD",
            "city": "KNIGHTSTOWN",
            "state": "IN",
            "postal_code": "46148",
            "telephone_number": "765-932-5533",
            "fax_number": "765-932-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CONRAD HARCOURT WAY",
            "city": "RUSHVILLE",
            "state": "IN",
            "postal_code": "461731100",
            "telephone_number": "765-932-5533",
            "fax_number": "765-932-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "JOHN",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darin Wade Wallace, DC
• David E Wenning, PHARMD
• Makenzie Renea Werner, NP
• Ryan S White, M.D.
• Rebecca Wilcher
• Jaclyn Williams
• Lachisha Marie Williamson
• Adam James Winters, D.D.S.
• Ron L. Winters, D.D.S.
• Randy Carl Young, D.D.S.

• General Practice Dentistry in Rushville, IN
• Providers in Rushville, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.