DR. ELIZABETH MARIE CLAFLIN WYDERKO (NPI# 1114048402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114048402 |
Entity Type | Individual |
Full Name | DR. ELIZABETH MARIE CLAFLIN WYDERKO |
Credential | D.D.S. |
Practice Address |
2215 Fuller Road Dental Service 160 Ann Arbor MI 48105 |
Mailing Address |
3043 Barclay Way Ann Arbor MI 48105-9464 |
Practice Telephone | 7347697100 |
Enumeration Date | 2007-04-03 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
2901019339 | MI | Dental Providers |
Street Address |
2215 FULLER ROAD DENTAL SERVICE 160 |
City | ANN ARBOR |
State | MI |
Zip Code | 48105 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750359527 | Jyotsna Kapoor | Internal Medicine | 2215 Fuller Road, Ann Arbor, MI 48105 | 2006-03-09 |
1700417581 | Michael Nolan | Pharmacist | 2215 Fuller Road, Db12, Ann Arbor, MI 48105 | 2020-01-30 |
1922450212 | Logan White | Dentist | 2215 Fuller Road, Vamc Dental Service (160), Ann Arbor, MI 48105-9923 | 2016-07-11 |
1003265091 | Ning Chang | Dentist | 2215 Fuller Road, Aavamc - Dental Service (160), Ann Arbor, MI 48105-9923 | 2016-06-09 |
1912273947 | Sandra Lee Houghtaling | Registered Nurse | 2215 Fuller Road, Ann Arbor, MI 48105-2303 | 2012-03-23 |
1689945594 | Susan Hansell | Registered Nurse | 2215 Fuller Road, Va Ann Arbor Healthcare System Mail Code 111e, Ann Arbor, MI 48105 | 2012-01-24 |
1427325661 | Cynthia A Horning | Registered Nurse | 2215 Fuller Road, Ann Arbor Va Medical Center, Ann Arbor, MI 48108 | 2011-11-16 |
1356678239 | Cynthia Ann Jachym | Registered Nurse | 2215 Fuller Road, Ann Arbor, MI 48105 | 2009-11-12 |
1295961241 | William B Cederquist | Anesthesiology | 2215 Fuller Road, Ann Arbor, MI 48105-2303 | 2009-06-04 |
1427132992 | Joleen Ann Wagner-felkey | Social Worker | 2215 Fuller Road, Ann Arbor, MI 48105-2338 | 2006-10-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730728718 | Alexander Jendrusina | Psychologist | Va Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105 | 2019-12-23 |
1417515875 | Christine Shyh Wang | Student in an Organized Health Care Education/Training Program | 4029 Avenue Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2019-05-31 |
1013475003 | Ryan Wang | Physician Assistant | 4883 S. Ridgeside Cir, Ann Arbor, MI 48105 | 2019-03-08 |
1801366265 | Amruta Sonavaria | Physical Therapist | 4701 East Huron River Drive, Ann Arbor, MI 48105 | 2018-11-28 |
1568955730 | Alexander Sliwicki | Pediatrics | 1500 East Medical Drive, Medical Professional Building, Ann Arbor, MI 48105 | 2018-06-12 |
1902398464 | Austin Remington | Student in an Organized Health Care Education/Training Program | 4029 Ave Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2018-05-31 |
1881191658 | Stephen James Hickner | Student in an Organized Health Care Education/Training Program | St. Mary Mercy Outpatient Psychiatric Services, 2006 Hogback Road, Suite 1, Ann Arbor, MI 48105 | 2018-04-09 |
1245681709 | Winnie Nhan | Internal Medicine | 4000 Ave Maria Dr, Lobby C Suite 1300, Ann Arbor, MI 48105 | 2016-06-27 |
1861857971 | Connie Chen | Pharmacist | 2215 Fuller Road (119), Ann Arbor, MI 48105 | 2015-12-17 |
1407241193 | Stefan Craciun | Emergency Medicine | 3484 Ashburnam Rd, Ann Arbor, MI 48105 | 2015-03-31 |
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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 |
---|---|---|---|---|
1659989341 | Steven Joseph Quell | Dentist | 3100 E Eisenhower Pkwy Ste 300, Ann Arbor, MI 48108-5205 | 2020-07-19 |
1699383695 | Laurich Dentistry Ann Arbor Pllc | Dentist | 2715 Packard St Ste B, Ann Arbor, MI 48108-3365 | 2020-07-16 |
1417573312 | Jiwon Lim | Dentist | 1500 E Medical Center Dr Fl 2c213, Ann Arbor, MI 48109-5000 | 2020-06-17 |
1518582337 | Emma Jean Mattei | Dentist | 2920 Tepeyac Hill Dr, Ann Arbor, MI 48105-9388 | 2020-06-09 |
1053935155 | Elijah Noronha | Dentist | 4814 Washtenaw Ave Apt B5, Ann Arbor, MI 48108-1446 | 2020-06-04 |
1114572609 | Chandani Patel | Dentist | 1250 Horseshoe Cir Apt 106, Ann Arbor, MI 48108-2424 | 2019-08-02 |
1215422266 | Lucy Marie Johnson | Dentist | Va Health Ann Arbor Dental Service, 2215 Fuller Road, Ann Arbor, MI 48105-2303 | 2018-06-22 |
1376052647 | Shivika Verma | Dentist | 3071 Signature Blvd, Apartment #f, Ann Arbor, MI 48103 | 2017-09-29 |
1003339391 | Celia Sommer | Dentist | 1011 North University Ave, Ann Arbor, MI 48109-1078 | 2017-07-19 |
1952823346 | Claudia M Varvara | Dentist | 811 E Summerfield Glen Circle, Ann Arbor, MI 48103-9161 | 2017-07-07 |
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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.