WILSON AND PFAU FAMILY DENTISTRY LLC (NPI# 1013534684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013534684 |
| Entity Type | Organization |
| Organization Name | WILSON AND PFAU FAMILY DENTISTRY LLC |
| Practice Address |
288 Northwood Ave Jasper IN 47546-1212 |
| Practice Telephone | 8124821855 |
| Practice Fax Number | 8126346833 |
| Mailing Telephone | 8124821855 |
| Mailing Fax Number | 8126346833 |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |
| Authorized Official Name | ALICIA BIES-PFAU (OWNER/OFFICE MANAGER) |
| Authorized Official Telephone | 8124821855 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | NPI (KIM BADELL WILSON DDS) | 1821215781 | 01 |
| IN | NPI (ALEX M PFAU DMD) | 1659755197 | 01 |
| IN | NPI (J BRAD WILSON DDS) | 1841417706 | 01 |
| Street Address |
288 NORTHWOOD AVE |
| City | JASPER |
| State | IN |
| Zip Code | 47546-1212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841417706 | J. Brad Wilson | Dentist | 288 Northwood Ave, Jasper, IN 47546-1212 | 2007-04-19 |
| 1659755197 | Alex Pfau | Dentist | 288 Northwood Ave, Jasper, IN 47546-1212 | 2015-07-15 |
| 1750576633 | Dr J Brad Wilson & Dr Kim Badell Wilson Inc | Dentist | 288 Northwood Ave, Jasper, IN 47546-1212 | 2007-09-13 |
| 1821215781 | Kim Badell Wilson | Dentist | 288 Northwood Ave, Jasper, IN 47546-1212 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497303572 | Marissa L Brosmer | Registered Nurse | 440 Scott Rolen Drive, Jasper, IN 47546 | 2019-08-30 |
| 1154887040 | Jesc LLC | Clinic/Center | 647 West Second Street Suite A, Jasper, IN 47546 | 2019-02-15 |
| 1427384858 | Therapro LLC | Clinic/Center | 306 1/2 Main Street, Jasper, IN 47546 | 2009-10-20 |
| 1255459780 | Billy Lee Berry | Counselor | 332 3rd Ave, Jasper, IN 47546 | 2007-03-26 |
| 1285776294 | Gregory K. Gordon | Optometrist | 471 Us 231 S, Jasper, IN 47546 | 2007-02-13 |
| 1902951312 | Urology Specialists PC | Urology | 1950 St Charles Street, Suite 3, Jasper, IN 47546 | 2007-01-24 |
| 1568548501 | Ralph E Mehling | Pharmacist | #435 Us 231 S, Jasper, IN 47546 | 2006-10-31 |
| 1962585430 | Heart To Heart Hospice of Southwest Indiana LLC | Hospice Care, Community Based | 415 E 6th St, Jasper, IN 47546 | 2006-10-20 |
| 1245347137 | Roy Elliott Cecchi | Obstetrics & Gynecology | 613 Dorbett Street, Jasper, IN 47546 | 2006-08-24 |
| 1093828790 | Sleep Management Institute LLC | Internal Medicine | 3157 Villa Way, Jasper, IN 47546 | 2006-08-16 |
| Find all providers in zip 47546 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194209650 | Ansley Parnell Allen | Dentist | 1208 Highway 78 East, Jasper, AL 35501 | 2018-09-20 |
| 1487069035 | Howard Ronald Brown | Dentist | 1606 Highway 78 E, Jasper, AL 35501-4034 | 2014-06-23 |
| 1356696058 | Southeast Texas Dental Center | Dentist | 190 N Zavalla St, Jasper, TX 75951-4119 | 2012-07-18 |
| 1548421860 | Steven G. Spencer | Dentist | 364 N Zavalla St, Jasper, TX 75951-3708 | 2008-06-19 |
| 1730358300 | Michael D. Adkins | Dentist | 1100 Woodlawn Dr, Jasper, IN 47546-8086 | 2008-02-27 |
| 1851598833 | Kelly Elizabeth Young | Dentist | 2005 Saint Charles St Ste 5, Jasper, IN 47546-9146 | 2007-07-02 |
| 1508068891 | Bradley Simpson Hicks | Dentist | 4500 Highway 78 E, Jasper, AL 35501-8804 | 2007-05-31 |
| 1124248406 | Jodi Lee Kahla | Dentist | 2051-e South Wheeler, Jasper, TX 75951-5600 | 2007-04-27 |
| 1427278175 | William Charles Fincannon | Dentist | 1001 W Gibson St, Jasper, TX 75951-4803 | 2007-04-26 |
| 1841417706 | J. Brad Wilson | Dentist | 288 Northwood Ave, Jasper, IN 47546-1212 | 2007-04-19 |
| Find all providers in JASPER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.