Individual provider Active NPI

John Christopher Wichmann, DMD

  • General Practice Dentistry
  • Beaver Falls, PA
National Provider Identifier
1972608750
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-020456-L-PA Issued in PA
Practice address
128 Blackhawk Rd
Beaver Falls, PA 15010
Phone
(724) 845-4280
Fax
(724) 843-4456
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 DS-020456-L-PA PA Primary

Addresses

Primary practice location

128 Blackhawk Rd
Beaver Falls, PA 15010

Mailing address

128 Blackhawk Rd
Beaver Falls, PA 15010
Phone (724) 845-4280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160328000935 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7618274259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS-020456-L-PAPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wichmann DMD & Hamerski DMD PC 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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972608750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 BLACKHAWK RD",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "15010",
            "telephone_number": "724-845-4280",
            "fax_number": "724-843-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 BLACKHAWK RD",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "15010",
            "telephone_number": "724-845-4280",
            "fax_number": "724-843-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "JOHN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-020456-L-PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Falls, PA

Sources for this page

Verify at the official NPI Registry.