Active NPI
J Stephen Wibbeler, DDS
- General Practice Dentistry
- Choteau, MT
National Provider Identifier
1891710067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1436
- Practice address
- 15 1St St NE
Choteau, MT 59422-0990 - Phone
- (406) 466-5662
- Fax
- (406) 466-5662
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1436 | MT | Primary |
Addresses
Primary practice location
15 1St St NE
Choteau, MT 59422-0990
Mailing address
15 1St St NE
Box 990
Choteau, MT 59422-0990
Phone (406) 466-5662
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11-9353 | Medicaid | MT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1436 | MT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allen Dental, PLLC | 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.
-
- Dentist
- Choteau, MT
- NPI 1003430570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891710067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 1ST ST NE",
"address_2": "BOX 990",
"city": "CHOTEAU",
"state": "MT",
"postal_code": "594220990",
"telephone_number": "406-466-5662",
"fax_number": "406-466-5662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 1ST ST NE",
"city": "CHOTEAU",
"state": "MT",
"postal_code": "594220990",
"telephone_number": "406-466-5662",
"fax_number": "406-466-5662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIBBELER",
"first_name": "J",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MT",
"license": "1436",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11-9353",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Choteau, MT
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.