DR. KENNETH BRUCE WEDDELL (NPI# 1104884147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104884147 |
| Entity Type | Individual |
| Full Name | DR. KENNETH BRUCE WEDDELL |
| Credential | DDS |
| Practice Address |
111 W Dayton St Fremont MI 49412 |
| Mailing Address |
111 W Dayton St Po Box 437 Fremont MI 49412 |
| Practice Telephone | 2319243600 |
| Practice Fax Number | 2319249720 |
| Mailing Telephone | 2319243600 |
| Mailing Fax Number | 2319249720 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 14503 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UN CONCORDIA | 847376 | 01 | |
| MI | BCBS | D808140 | 01 |
| Street Address |
111 W DAYTON ST |
| City | FREMONT |
| State | MI |
| Zip Code | 49412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730161175 | Kenneth B Weddell Dds PC | Dentist | 111 W Dayton St, Fremont, MI 49412-1112 | 2005-11-18 |
| 1568777290 | Walter I. Coleman, Dds, Pllc | Clinic/Center | 111 W Dayton St, Fremont, MI 49412-1112 | 2010-08-18 |
| 1487612842 | Jennifer M Boyd | Dentist | 111 W Dayton St, Fremont, MI 49412 | 2006-05-03 |
| 1437116316 | Walter I Coleman | Dentist | 111 W Dayton St, Fremont, MI 49412 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437632437 | Claire Marie J Derks | Massage Therapist | 119 North Stone Road, Fremont, MI 49412 | 2018-09-14 |
| 1730565946 | Retirement Living Management of Fremont, L.L.C. | Assisted Living Facility | 801 E. Main Street, Fremont, MI 49412 | 2015-08-11 |
| 1497136410 | James Yon | Social Worker | 3682 S Maple Island Rd, Fremont, MI 49412 | 2015-06-16 |
| 1871864090 | Cheryl Lee Kublin | Specialist | 4554 W. 48th St, Fremont, MI 49412 | 2012-01-19 |
| 1326319583 | Colleen M Rice | Occupational Therapist | 4554 W. 48th Street, Fremont, MI 49412 | 2012-01-19 |
| 1154578847 | Greenlund Enterprises, Inc | Hearing Aid Equipment | 28 Wet Sheridan Street, Fremont, MI 49412 | 2008-08-25 |
| 1225170699 | Raymond Prins IIi | Dentist | 855 N Darling, Fremont, MI 49412 | 2007-02-13 |
| 1508933789 | Charles Merle Erickson | Dentist | 16 W Sheridan, Fremont, MI 49412 | 2006-11-30 |
| 1588741300 | Christopher Callis Niquette | Dentist | 327 Apache Dr, Fremont, MI 49412 | 2006-11-01 |
| 1417041179 | Newaygo County Resa | Local Education Agency (LEA) | 4747 W. 48th Street, Fremont, MI 49412 | 2006-10-03 |
| Find all providers in zip 49412 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407473911 | Shyamli V Shah | Dentist | 4205 Mowry Ave Apt 6, Fremont, CA 94538-1265 | 2020-06-30 |
| 1992337067 | Amun Rattan | Dentist | 2820 Calvin Ct, Fremont, CA 94536-5227 | 2020-02-06 |
| 1093368391 | Adam Stump | Dentist | 1003 W Toledo St, Fremont, IN 46737-2075 | 2019-07-17 |
| 1942774989 | Hercules Dental Care In Fremont | Dentist | 556 Mowry Ave Ste 203, Fremont, CA 94536-4186 | 2019-01-13 |
| 1235607169 | Arifa Shaikh | Dentist | 3456 Mowry Ave, Fremont, CA 94538-1422 | 2018-11-08 |
| 1598230161 | Emily Zheng | Dentist | 34400 Fremont Blvd, Fremont, CA 94555-3322 | 2018-10-09 |
| 1225523541 | Sara Saber | Dentist | 194 Francisco Ln Ste 112, Fremont, CA 94539-7924 | 2018-06-28 |
| 1932628757 | Shweta Parulekar | Dentist | 34232 Hogan Ter, Fremont, CA 94555-3839 | 2017-09-13 |
| 1689123275 | Amy Chang | Dentist | 3705 Beacon Ave Ste 101, Fremont, CA 94538-1467 | 2016-09-24 |
| 1942754536 | Donald Lane | Dentist | 46921 Warm Springs Blvd, Fremont, CA 94539-7933 | 2016-08-11 |
| Find all providers in FREMONT | ||||
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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.