DR. ANDREW EVERETT WICKE (NPI# 1386081628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386081628 |
| Entity Type | Individual |
| Full Name | DR. ANDREW EVERETT WICKE |
| Credential | D.M.D. |
| Practice Address |
131 Indian Lake Blvd Ste 100 Hendersonville TN 37075-6207 |
| Practice Telephone | 6158228403 |
| Practice Fax Number | 6155377696 |
| Mailing Telephone | 6158228403 |
| Mailing Fax Number | 6155377696 |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9682 | TN | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | 9682 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1623 The Vanderbilt Clinic, Dept. of Omfs, V.u. Medical Center, Nashville, TN 372320001 | 6153439404 |
| Street Address |
131 INDIAN LAKE BLVD STE 100 |
| City | HENDERSONVILLE |
| State | TN |
| Zip Code | 37075-6207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114346137 | Joseph Roman Mort | Dentist | 131 Indian Lake Blvd Ste 100, Hendersonville, TN 37075 | 2014-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667425 | Results-ast Jv, LLC | Physical Therapist | 326 New Shackle Island Rd, Suite 300, Hendersonville, TN 37075 | 2020-10-21 |
| 1871126524 | Jessica Elise Williams | Nurse Practitioner | 100 Indian Lake Blvd, Hendersonville, TN 37075 | 2020-02-20 |
| 1003379108 | Infusion Express of Tennessee, PC | Clinic/Center | 1006 Glenbrook Way, Ste 130, Hendersonville, TN 37075 | 2019-04-08 |
| 1417414335 | Red Owl Industries, LLC | Chiropractor | 16 Executive Park Dr # 100, Hendersonville, TN 37075 | 2019-02-27 |
| 1992203368 | Cassie Berman | Occupational Therapist | 209 Shivel Drive, Hendersonville, TN 37075 | 2018-01-31 |
| 1407379373 | Hendersonville Smiles Dentistry, PC | Dentist | 1002 Glenbrook Way, Suite 200, Hendersonville, TN 37075 | 2017-07-21 |
| 1215483466 | Ryan Escue | Registered Nurse | 4221 Harding Pike, Nashville, TN 37075 | 2016-08-28 |
| 1003279589 | Grant Anderson | Physician Assistant | 211 Indian Lake Bloulevard, Hendersonville, TN 37075 | 2016-04-01 |
| 1073974192 | Jennifer Kramer | Nurse Practitioner | 103 Hazel Path Ct, Suite 7, Hendersonville, TN 37075 | 2016-03-16 |
| 1144680315 | Catherine Alexandria Wellendorf | Specialist/Technologist | 3126 Long Hollow Pike, Hendersonville, TN 37075 | 2016-03-02 |
| Find all providers in zip 37075 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972687028 | Dr. Ty E. Hornsby | Dentist | 902 Fleming St., Hendersonville, NC 28791 | 2006-10-25 |
| 1477573590 | Ty E Hornsby | Dentist | 902 Fleming St, Hendersonville, NC 28791-3517 | 2006-07-20 |
| 1194707919 | Daniel C. Burchfield | Dentist | 131 Indian Lake Blvd, Suite 100, Hendersonville, TN 37075-6210 | 2005-11-17 |
| 1114346137 | Joseph Roman Mort | Dentist | 131 Indian Lake Blvd Ste 100, Hendersonville, TN 37075 | 2014-04-08 |
| 1730459181 | Jeffrey Allen Riggs | Dentist | 131 Indian Lake Blvd, Suite 100, Hendersonville, TN 37075-6210 | 2012-01-03 |
| 1780731653 | Kevin D. West | Dentist | 131 Indian Lake Blvd, Suite 100, Hendersonville, TN 37075-6210 | 2007-01-04 |
| 1508843913 | William Henry Logan IIi | Dentist | 1216 6th Ave W, Suite E, Hendersonville, NC 28739-3312 | 2005-12-28 |
| 1447232830 | John K. Shea | Dentist | 131 Indian Lake Blvd, Suite 100, Hendersonville, TN 37075-6210 | 2005-11-19 |
| 1457333270 | Gregory P Richardson | Dentist | 131 Indian Lake Blvd, Suite 100, Hendersonville, TN 37075-6210 | 2005-11-17 |
| 1861474694 | Daniel C. Burchfield, Dmd Et Al Ptr. | Dentist | 131 Indian Lake Blvd, Suite 100, Hendersonville, TN 37075-6210 | 2005-11-17 |
| Find all providers in HENDERSONVILLE | ||||
| City | HENDERSONVILLE |
| Zip Code | 37075 |
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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.