Individual provider Active NPI

Gary Paul Wheelr, D.D.S.

  • General Practice Dentistry
  • Lynn, MA
National Provider Identifier
1861688335
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14804 Issued in MA
Practice address
389 Broadway
Lynn, MA 01904-2629
Phone
(781) 595-7953
Fax
(781) 592-6861
NPI assigned
Sep 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14804 MA Primary

Addresses

Primary practice location

389 Broadway
Lynn, MA 01904-2629

Mailing address

389 Broadway
Lynn, MA 01904-2629
Phone (781) 595-7953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150528002595 MA Order and Referring Only - DentistPractitioner - Dentist 9133449358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14804MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary P Wheeler DDS Inc General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1861688335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 BROADWAY",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042629",
            "telephone_number": "781-595-7953",
            "fax_number": "781-592-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 BROADWAY",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019042629",
            "telephone_number": "781-595-7953",
            "fax_number": "781-592-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELR",
        "first_name": "GARY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.