DR. KENDALL MARIE WACHTER (NPI# 1629293709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629293709 |
| Entity Type | Individual |
| Full Name | DR. KENDALL MARIE WACHTER |
| Credential | DMD |
| Practice Address |
374 E Grand Ave Student Health Center Siuc Carbondale IL 62901 |
| Mailing Address |
520 Canary Lane Carterville IL 62918 |
| Practice Telephone | 6185362421 |
| Practice Fax Number | 6184533477 |
| Mailing Telephone | 6189856997 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| Street Address |
374 E GRAND AVE STUDENT HEALTH CENTER SIUC |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124064035 | Southern Illinois University Student | Pharmacy | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2006-06-20 |
| 1134748635 | Warren Thomas Bush | Psychologist | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2020-04-14 |
| 1639715543 | Paul Eric Winchester | Physical Therapy Assistant | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2019-11-26 |
| 1952947004 | Jennifer Winchester | Physical Therapy Assistant | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2019-11-25 |
| 1992210975 | Alec Eshelman | Psychologist | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2017-12-12 |
| 1780133165 | Thomas Norbert Cerny | Pharmacist | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2016-09-27 |
| 1871834200 | Kyle Michael Chamness | Physical Therapy Assistant | 374 E Grand Ave, Carbondale, IL 62901-3962 | 2013-03-11 |
| 1780921312 | Christy L Hamilton | Counselor | 374 E Grand Ave, Mail Code 6740, Carbondale, IL 62901-3962 | 2013-01-16 |
| 1659617884 | Rosemary Elizabeth Simmons | Psychologist | 374 E Grand Ave, Counseling Center, Mail Code 4715, Siu, Carbondale, IL 62901-3962 | 2012-12-16 |
| 1639397128 | Russell Edward Klein | Dentist | 374 E Grand Ave, Student Health Center Sivc, Carbondale, IL 62901 | 2007-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| 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 |
|---|---|---|---|---|
| 1487049698 | Mark A Cook Dds PC | Dentist | 60 S 8th St Suite 201, Carbondale, CO 81623-1929 | 2015-04-03 |
| 1427357631 | Dental Safari Company, Ltd | Dentist | 800 E Walnut St, Suite A, Carbondale, IL 62901-3142 | 2011-03-28 |
| 1053647032 | Ralph Kimbrough | Dentist | 402 S. Lewis Ln, Carbondale, IL 62901-3547 | 2009-10-26 |
| 1487810461 | S. Michael Vancil | Dentist | 1255 Cedar Ct, Carbondale, IL 62901-5335 | 2008-07-30 |
| 1477716926 | Alice A Kaniff | Dentist | 326 Highway 133 Ste 270h, Carbondale, CO 81623-2510 | 2008-07-04 |
| 1487867750 | Lifetime Dental Care of Illinois, PC | Dentist | 1366 E Main, Carbondale, IL 62901 | 2007-05-07 |
| 1023230281 | Lifetime Dental Care of Illinois, PC | Dentist | 1001 E Main, Carbondale, IL 62901 | 2007-05-03 |
| 1831259175 | Gerald G Salko | Dentist | 59 7th Ave, Carbondale, PA 18407-2320 | 2006-12-09 |
| 1093883647 | Dianna Gail Gaultney | Dentist | 207 N University Ave, Carbondale, IL 62901-1445 | 2006-12-01 |
| 1982774659 | Dominic Cittadino | Dentist | 305 S Oakland Ave, Carbondale, IL 62901-2545 | 2006-11-09 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on DR. KENDALL MARIE WACHTER.
| 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.