Wild Child Orthodontics

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WILD CHILD ORTHODONTICS

Doing business as

Veil & Wild Orthodontics

Practice address

17677 Cedar Ave
Lakeville, MN 55044-2250

Phone

(952) 903-9484

Fax

(952) 941-7091

NPI assigned

May 31, 2023

Last updated

May 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Wild, DDSNPI 1043500648

Title

Doctor

Phone

(952) 903-9484

Specialties & licenses 1

Addresses

Other names 1

• Veil & Wild Orthodontics Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin Richard Wild, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Eden Prairie, MN
  • NPI 1043500648
  NPD Authorized official
• Jesse N Veil, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Eden Prairie, MN
  • NPI 1215981246
  NPD (past)

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1972296481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 SINGLETREE LN STE 200",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445397",
            "telephone_number": "952-903-9484",
            "fax_number": "952-941-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17677 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550442250",
            "telephone_number": "952-903-9484",
            "fax_number": "952-941-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD CHILD ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "WILD",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "952-903-9484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Veil & Wild Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie A Whipple, PHARMD, RPH
• White Lily Acupuncture LLC
• Brittany Michelle White, PT, DPT
• Michele Jacqueline White, MA
• Wholemind Wellness and Psychiatry
• Ava Wilk
• Kelly Lee Wilkinson, MA, LPCC
• Asya Williams
• Hannah Williams, LMFT
• Kimberly Williams

• Dental Clinic/Center in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.