CHARLES WISEMAN (NPI# 1033536800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033536800 |
| Entity Type | Individual |
| Full Name | CHARLES WISEMAN |
| Credential | D.D.S. |
| Practice Address |
2509 Pico Blvd Santa Monica CA 90405-1828 |
| Practice Telephone | 3103928636 |
| Mailing Telephone | 3103928636 |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2016-11-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 26245 | CA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
26245 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063975423 | Charles Edward Wiseman | Private Vehicle | 8091 Sw 4th St, Blue Springs, MO 64014-7846 | 2019-04-11 |
| 1962493551 | Charles Louis Wiseman | Specialist | 8900 Wilshire Blvd, Second Floor, Beverly Hills, CA 90211-1958 | 2005-11-02 |
| Street Address |
2509 PICO BLVD |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90405-1828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245274125 | John A Roohan | Family Medicine | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2006-06-15 |
| 1871966812 | Rainy L Sawicki | Dental Hygienist | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2015-11-12 |
| 1619343118 | Venice Family Clinic | Clinic/Center | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2015-08-19 |
| 1982087128 | Susanne Kathleen Cohen | Nurse Practitioner | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2015-07-07 |
| 1053660720 | Venice Family Clinic | Clinic/Center | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2012-09-10 |
| 1780930867 | Katherine Elena Asmuth | Registered Nurse | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2012-07-26 |
| 1528333275 | Erica Denley | Dentist | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2012-03-14 |
| 1770868549 | Maria J Enriquez | Social Worker | 2509 Pico Blvd, 3rd Floor, Santa Monica, CA 90405-1828 | 2011-10-12 |
| 1801110168 | Jacqueline Heller | Psychiatry & Neurology | 2509 Pico Blvd, 3rd Floor, Santa Monica, CA 90405-1828 | 2010-03-16 |
| 1144451345 | Diana Hoffman | Family Medicine | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2009-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328476 | Nicole Ryan Harbeck | Marriage & Family Therapist | 2716 Ocean Park Blvd Ste 2007, Santa Monica, CA 90405 | 2019-07-19 |
| 1922664440 | Betty Ann Wise | Counselor | 1865 W. 9th Street, Santa Monica, CA 90405 | 2019-05-10 |
| 1790203776 | Ernest Jones Jr. | Counselor | 909 Pico Blvd., Santa Monica, CA 90405 | 2017-08-30 |
| 1285171371 | Jori Adler Marriage & Family Therapy Prof. Corp. | Marriage & Family Therapist | 3400 Airport Ave Ste 30, Santa Monica, CA 90405 | 2017-01-26 |
| 1376993147 | Damoan Corp. | Speech-Language Pathologist | 2801 Ocean Park Blvd Ste 393, Santa Monica, CA 90405 | 2016-06-13 |
| 1427410034 | Adam Rubio | Clinical Neuropsychologist | 1916 4th Street, Santa Monica, CA 90405 | 2016-03-23 |
| 1760852842 | Yramnna Smith | Behavioral Analyst | 2716 Ocean Park Blvd Ste 1025, Santa Monica, CA 90405 | 2015-10-01 |
| 1689086076 | Cheryl K. Baker | Community Health Worker | 1750 Ocean Park Blvd., Suite 206, Santa Monica, CA 90405 | 2014-05-20 |
| 1629409891 | Dominique M. Delvecchio | Nurse Practitioner | 2716 Ocean Park Blvd. Suite 3082, Institute for Nerve Medicine, Santa Monica, CA 90405 | 2013-12-12 |
| 1639512692 | Nancy Elizabeth Hyland | Marriage & Family Therapist | 1720 Ocean Park Blvd, Suite 200a, Santa Monica, CA 90405 | 2013-04-09 |
| Find all providers in zip 90405 | ||||
| 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 |
|---|---|---|---|---|
| 1013524800 | Shantel Noghrey Ramin | Dentist | 2903 Delaware Ave, Santa Monica, CA 90404-5014 | 2020-09-25 |
| 1255993069 | Omeed Mahboobian | Dentist | 829 26th St, Santa Monica, CA 90403-2201 | 2019-07-01 |
| 1477030369 | Jennifer Garcia | Dentist | 2901 Wilshire Blvd Ste 255, Santa Monica, CA 90403 | 2018-07-23 |
| 1265815369 | Kevin Lee | Dentist | 1821 Wilshire Blvd Ste 646, Santa Monica, CA 90403-5674 | 2015-07-07 |
| 1700159829 | Gary Warburton | Dentist | 519 Arizona Ave., Santa Monica, CA 90401 | 2012-02-21 |
| 1922309574 | Adrienne Vera Hecht | Dentist | 1317 26th St Apt 2, Santa Monica, CA 90404-2020 | 2010-11-13 |
| 1316253016 | William Chin | Dentist | 1253 7th St, Suite 200, Santa Monica, CA 90401-1617 | 2010-08-19 |
| 1134431513 | Benjamin Freed | Dentist | 2730 Wilshire Blvd Ste 201, Santa Monica, CA 90403-4744 | 2010-07-13 |
| 1275782641 | Elliot Paul Schlang Dds Professional Corporation | Dentist | 240 18th St, Santa Monica, CA 90402-2404 | 2008-09-10 |
| 1932355385 | David Youssefi | Dentist | 2428 Santa Monica Blvd Ste 403, Santa Monica, CA 90404-2047 | 2008-08-15 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90405 |
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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.