DR. MICHAEL J WINE (NPI# 1245353168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245353168 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J WINE |
| Credential | DDS |
| Practice Address |
610 W Broadway Ave Jackson WY 83001-8213 |
| Mailing Address |
6797 Shire Ridge Dr Victor ID 83455-5036 |
| Practice Telephone | 3077322273 |
| Practice Fax Number | 3077321660 |
| Mailing Telephone | 6146486657 |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2016-09-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D 4424 | ID | Dental Providers |
| Y | 122300000X | Dentist | 1325 | WY | Dental Providers |
| Street Address |
610 W BROADWAY AVE |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255871018 | Danielle Christensen | Social Worker | 610 W Broadway Ave, Ste L1, Jackson, WY 83001-8213 | 2017-02-27 |
| 1841665668 | Anne Ellingson | Counselor | 610 W Broadway Ave, Suite L1, Jackson, WY 83001-8213 | 2015-12-04 |
| 1144603598 | Dustin Rifkin | Counselor | 610 W Broadway Ave, Jackson, WY 83001-8213 | 2015-07-02 |
| 1316346497 | Julie Elledge | Marriage & Family Therapist | 610 W Broadway Ave, 109, Jackson, WY 83001-8213 | 2014-08-14 |
| 1265844815 | Ryan Burke | Counselor | 610 W Broadway Ave, Ste L1, Jackson, WY 83001-8213 | 2014-05-29 |
| 1033535216 | Jonathan Figg | Internal Medicine | 610 W Broadway Ave, Suite 108, Jackson, WY 83001-8213 | 2014-03-11 |
| 1952662751 | Jonathon C Baillie | Counselor | 610 W Broadway Ave, Jackson, WY 83001-8213 | 2012-06-07 |
| 1881973345 | Thekla Margaret Vonhagke | Counselor | 610 W Broadway Ave, Suite L 1, Jackson, WY 83001-8213 | 2011-08-15 |
| 1053647990 | Samantha Baillie | Counselor | 610 W Broadway Ave, Suite L 1, Jackson, WY 83001-8213 | 2009-10-28 |
| 1457500860 | Allison Walsh-day | Social Worker | 610 W Broadway Ave, Jackson, WY 83001-8213 | 2008-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| 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 |
|---|---|---|---|---|
| 1619595295 | Charles Austin Huffman | Dentist | 1189 E County Line Rd, Jackson, MS 39211-1836 | 2020-07-09 |
| 1184249278 | Sleep Better Solutions LLC | Dentist | 9 Chatwick Cv, Jackson, TN 38305-5642 | 2020-06-15 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1124689864 | Hannah Farrar | Dentist | 2064 S Highland Ave, Jackson, TN 38301-7741 | 2019-06-24 |
| 1417515214 | Richard Yoo | Dentist | 3857 Cooper St Ofc, Jackson, MI 49201-7547 | 2019-06-05 |
| 1487148078 | Tanvi Patil | Dentist | 1074 Jackson Crossing, Jackson, MI 49202-2039 | 2018-06-18 |
| 1487183737 | Arkady Khaykin | Dentist | 24 N Cooks Bridge Rd, Jackson, NJ 08527 | 2017-06-09 |
| 1497292239 | Advanced Dental Clinic | Dentist | 1555 E County Line Road, Jackson, MS 39211 | 2017-01-31 |
| 1598131336 | S Kaur Dds Inc | Dentist | 12120 Industry Blvd Ste 35, Jackson, CA 95642-9374 | 2015-08-17 |
| 1841675931 | Miriam Tygier Furlong | Dentist | 186 W Veterans Hwy, Jackson, NJ 08527-3410 | 2015-07-30 |
| Find all providers in JACKSON | ||||
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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.