Individual provider Active NPI

Matthew Wellejus, DMD

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1962412270
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.020775 Issued in OH
Practice address
420 N James Rd
Columbus, OH 43219-1834
Phone
(614) 257-5432
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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 30.020775 OH Primary

Addresses

Primary practice location

420 N James Rd
Columbus, OH 43219-1834

Mailing address

420 N James Rd
Columbus, OH 43219-1834
Phone (614) 257-5432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140508001282 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2668605072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1962412270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834",
            "telephone_number": "614-257-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834",
            "telephone_number": "614-257-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLEJUS",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.020775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.