Nicholas L. Wengrin, D.M.D., F.A.G.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-022881-L Issued in PA

Practice address

4810 Horseshoe Pike
Honey Brook, PA 19344

Phone

(610) 273-3553

Fax

(610) 273-9381

NPI assigned

Dec 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

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 Apr 8, 2016 through Apr 8, 2028

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Honey Brook Dental LLC

  • Dental Clinic/Center
  • Honey Brook, PA
  • NPI 1215778162
  NPD (past)

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811052327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 550 4810 HORSESHOE PIKE",
            "city": "HONEY BROOK",
            "state": "PA",
            "postal_code": "19344",
            "telephone_number": "610-273-3553",
            "fax_number": "610-273-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 HORSESHOE PIKE",
            "city": "HONEY BROOK",
            "state": "PA",
            "postal_code": "19344",
            "telephone_number": "610-273-3553",
            "fax_number": "610-273-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGRIN",
        "first_name": "NICHOLAS",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.M.D., F.A.G.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-022881-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD-UC",
            "identifier": "172088",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Deborah Tabernik, BS
• Tel Hai Retirement Community
• The Rehab Center
• Thrive Pelvic Therapy LLC
• Taren Weidner, PTA
• Molly Marie Wilson, DC
• Angela Marie Wimer, D.M.D.
• Joanne Zwierzyna

• General Practice Dentistry in Honey Brook, PA
• Providers in Honey Brook, PA by specialty
• General Practice Dentistry in Pennsylvania

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.