MR. JOHN P WIEDERHOLT (NPI# 1336369073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336369073 |
| Entity Type | Individual |
| Full Name | MR. JOHN P WIEDERHOLT |
| Credential | DMD |
| Practice Address |
3434 E. Washington Ave Madison WI 53704-4155 |
| Mailing Address |
2901 W. Beltline Hwy. Ste. 120 Madison WI 53713-4226 |
| Practice Telephone | 6084435550 |
| Practice Fax Number | 6084435554 |
| Mailing Telephone | 6084435500 |
| Mailing Fax Number | 6084411981 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2011-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 6263-15 | WI | Dental Providers |
| N | 122300000X | Dentist | 6263-015 | WI | Dental Providers |
| N | 122300000X | Dentist | 21644 | MA | Dental Providers |
| Street Address |
3434 E. WASHINGTON AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53704-4155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| 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 |
|---|---|---|---|---|
| 1548875305 | Andre Oliveira-shahinfar | Dentist | 6038 Gemini Dr, Madison, WI 53718-3008 | 2020-09-09 |
| 1689286254 | Rajdeepsinh Narendrasinh Dolia | Dentist | 12205 County Line Rd Ste A, Madison, AL 35758-7720 | 2020-08-17 |
| 1841815362 | Payalben Baldev Patel | Dentist | 117 Fontanelle Blvd, Madison, MS 39110-6846 | 2020-06-10 |
| 1649824830 | Applewhite Dental Wisconsin, P.C. | Dentist | 5610 Medical Cir Ste 10, Madison, WI 53719-1284 | 2019-07-26 |
| 1336792787 | Mary Catherine Decker | Dentist | 8002 Watts Rd, Madison, WI 53719-3811 | 2019-07-24 |
| 1639739345 | Matthew Douglas Smith | Dentist | 500 Lentz Dr Ste 90a, Madison, TN 37115-5135 | 2019-06-14 |
| 1790277432 | Allison Reimer | Dentist | 4602 E Washington Ave, Madison, WI 53704-3236 | 2018-05-30 |
| 1629599683 | Melissa Ashlee Morrison | Dentist | 7617 Mineral Point Rd Ste 120, Madison, WI 53717-1623 | 2017-06-29 |
| 1336692417 | Danielle Marie Meirick | Dentist | 434 Sidney St, Madison, WI 53703-1724 | 2016-07-26 |
| 1649648858 | Terry A. Burgess | Dentist | 810 Palmer Plaza, # 103, Madison, AL 35758 | 2015-09-03 |
| Find all providers in MADISON | ||||
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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.