Individual provider Active NPI

Andrew Frederick Wetterlind, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Baton Rouge, LA
National Provider Identifier
1871882480
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7139 Issued in LA
Practice address
13730 Millerville Greens Blvd
Baton Rouge, LA 70816-1696
Phone
(225) 234-0713
NPI assigned
Apr 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D12943 MN
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7139 LA Primary

Addresses

Primary practice location

13730 Millerville Greens Blvd
Baton Rouge, LA 70816-1696

Mailing address

324 Silver Creek Dr
Vicksburg, MS 39180-5484

Other practice location 1

70383 Highway 21 # 200
Covington, LA 70433-7150
Phone (985) 590-6287

Other practice location 2

1050 E Admiral Doyle Dr # C
New Iberia, LA 70560-6711
Phone (337) 321-5001

Other practice location 3

2240 Veterans Memorial Blvd
Kenner, LA 70062-5673
Phone (504) 405-3870

Other practice location 4

119 S Airline Hwy
Gonzales, LA 70737-3633
Phone (225) 308-3435

Other practice location 5

2807 W Thomas St
Hammond, LA 70401
Phone (985) 277-3355

Other practice location 6

1677 Gause Blvd
Slidell, LA 70458-2209
Phone (985) 718-3174

Other practice location 7

1708 Martin Luther King Jr Blvd # 101
Houma, LA 70360-2408
Phone (985) 746-9886

Other practice location 8

5540 Johnston St
Lafayette, LA 70503-5138
Phone (337) 247-7698

Other practice location 9

3411 Nelson Rd Ste 100
Lake Charles, LA 70605-1240
Phone (337) 602-9733

Other practice location 10

4964 Lapalco Blvd
Marrero, LA 70072-4371
Phone (504) 784-5642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7139LAMDOral and Maxillofacial Surgery (Dentist)
D12943MNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Tanika Hale DDS LLC PastSince Aug 18, 2024 Accepting new patients
Kacey Guillory DDS Professional Dental LLC PastSince Oct 30, 2022 Accepting new patients
Chedly Schatzie Vincent DMD LLC Past Accepting new patients
Jeffery Riso DDS LLC PastSince Jun 15, 2021 Accepting new patients

Organizations & group practices 4

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1871882480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 SILVER CREEK DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13730 MILLERVILLE GREENS BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708161696",
            "telephone_number": "225-234-0713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70383 Highway 21 # 200",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704337150",
            "country_code": "US",
            "telephone_number": "985-590-6287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 E Admiral Doyle Dr # C",
            "address_purpose": "LOCATION",
            "city": "New Iberia",
            "state": "LA",
            "postal_code": "705606711",
            "country_code": "US",
            "telephone_number": "337-321-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2240 Veterans Memorial Blvd",
            "address_purpose": "LOCATION",
            "city": "Kenner",
            "state": "LA",
            "postal_code": "700625673",
            "country_code": "US",
            "telephone_number": "504-405-3870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 S Airline Hwy",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707373633",
            "country_code": "US",
            "telephone_number": "225-308-3435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2807 W Thomas St",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "70401",
            "country_code": "US",
            "telephone_number": "985-277-3355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1677 Gause Blvd",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704582209",
            "country_code": "US",
            "telephone_number": "985-718-3174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1708 Martin Luther King Jr Blvd # 101",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "703602408",
            "country_code": "US",
            "telephone_number": "985-746-9886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5540 Johnston St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705035138",
            "country_code": "US",
            "telephone_number": "337-247-7698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3411 Nelson Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706051240",
            "country_code": "US",
            "telephone_number": "337-602-9733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4964 Lapalco Blvd",
            "address_purpose": "LOCATION",
            "city": "Marrero",
            "state": "LA",
            "postal_code": "700724371",
            "country_code": "US",
            "telephone_number": "504-784-5642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETTERLIND",
        "first_name": "ANDREW",
        "middle_name": "FREDERICK",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D12943",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "7139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.