DR. WILLARD WILLIAM WENTZ JR. (NPI# 1770569691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770569691 |
| Entity Type | Individual |
| Full Name | DR. WILLARD WILLIAM WENTZ JR. |
| Credential | DDS |
| Practice Address |
501 Rison St Stratford Medical Plaza Danville VA 24541-2458 |
| Practice Telephone | 4347925134 |
| Practice Fax Number | 4347912919 |
| Mailing Telephone | 4347925134 |
| Mailing Fax Number | 4347912919 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
0438000171 | VA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC MEDICAID | 899-9122 | 01 |
| VA | ANTHEM ID | 050010 | 01 |
| Street Address |
501 RISON ST STRATFORD MEDICAL PLAZA |
| City | DANVILLE |
| State | VA |
| Zip Code | 24541-2458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699757823 | Charles Edward Kober | Physician Assistant | 501 Rison St, Danville, VA 24541-2458 | 2005-11-15 |
| 1912369489 | Viola Jones | Nurse Practitioner | 501 Rison St, Danville, VA 24541-2425 | 2016-03-24 |
| 1689718736 | Danville Gastroenterology Center, PC | Internal Medicine | 501 Rison St, Suite 130, Danville, VA 24541-2458 | 2007-02-20 |
| 1811905615 | Claudia T Perkins | Nurse Practitioner | 501 Rison St, Suite 120, Danville, VA 24541-2425 | 2006-08-04 |
| 1902835325 | Mukesh B. Patel | Internal Medicine | 501 Rison St, Suite#130, Danville, VA 24541-2458 | 2006-06-30 |
| 1740222843 | Rajendra S Trivedi | Family Medicine | 501 Rison St, Suite 120, Danville, VA 24541-2458 | 2006-06-12 |
| 1295777654 | Bhushan H. Pandya | Internal Medicine | 501 Rison St, Suite 130, Danville, VA 24541-2458 | 2006-06-11 |
| 1922056290 | Karen L Mcclure | Nurse Practitioner | 501 Rison St, Suite 120, Danville, VA 24541-2425 | 2006-05-05 |
| 1376510644 | Memorial Family Care Inc | Family Medicine | 501 Rison St, Suite 120, Danville, VA 24541-2425 | 2006-03-04 |
| 1265418198 | Herbert C Manry | Dentist | 501 Rison St, Stratford Medical Plaza, Danville, VA 24541-2458 | 2005-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104303551 | Damon Lee Simpson | Occupational Therapy Assistant | 1616 Maple Dr, Danville, VA 24541 | 2018-07-27 |
| 1578065041 | Strategic Therapy Associates, Inc. | Transportation Broker | 1225 W Main Street, Danville, VA 24541 | 2018-03-01 |
| 1790291078 | Vicente T Falgui Md PC | Internal Medicine | 990 Main Street, Suite 204, Danville, VT 24541 | 2017-12-21 |
| 1558884270 | Focus Point Mental Health, LLC | Community/Behavioral Health | 116 Magnolia Drive, Danville, VA 24541 | 2017-07-25 |
| 1073045522 | Brittney Paige Throckmorton-samples | Physical Therapist | 174 Executive Drive, Danville, VA 24541 | 2017-04-03 |
| 1114378106 | Laurie Rich Taylor | Nurse Practitioner | 541 Bridge Street, Suite 1, Danville, VA 24541 | 2016-06-30 |
| 1285085779 | Larry Keller | Counselor | 1555 Meadowview Dr Ste 5, Danville, VA 24541 | 2016-06-25 |
| 1952617474 | Joshua Home Family Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 223 Randolph Street, Danville, VA 24541 | 2010-08-21 |
| 1922274661 | Blankenship & Davis Opticians Inc | Eyewear Supplier (Equipment, not the service) | 625 West Main Street, Danville, VA 24541 | 2008-05-02 |
| 1750588307 | Tiffany Devon Clark | Physical Therapy Assistant | 432 Hermitage Dr., Danville, VA 24541 | 2007-06-28 |
| Find all providers in zip 24541 | ||||
| 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 |
|---|---|---|---|---|
| 1366058604 | Sherwood Oral Surgery | Dentist | 174b Executive Dr, Danville, VA 24541-4100 | 2020-09-22 |
| 1124482237 | Colin Sherwood | Dentist | 174 Executive Dr Ste B, Danville, VA 24541-4100 | 2016-04-06 |
| 1285761411 | Kian Farzaneh D.d.s., Inc | Dentist | 903 San Ramon Valley Blvd Ste 126, Danville, CA 94526-4049 | 2007-02-27 |
| 1982621942 | Kian Farzaneh | Dentist | 801 San Ramon Valley Blvd Ste A, Danville, CA 94526-4027 | 2006-07-16 |
| 1114981420 | Louis M. Beto | Dentist | 400 S 4th St, Danville, KY 40422-2007 | 2006-04-13 |
| 1528222080 | Justin J Au | Dentist | 100 N Academy Ave, Danville, PA 17822-9800 | 2008-07-14 |
| 1376704452 | Edmund Ying-peng Wun | Dentist | 100 N Academy Ave, Danville, PA 17822-7104 | 2008-06-20 |
| 1215992854 | Arthur A. Gonty | Dentist | 400 S 4th St, Danville, KY 40422-2007 | 2006-04-18 |
| 1558325878 | Amy Jane Bogardus | Dentist | 400 S 4th St, Danville, KY 40422-2007 | 2006-04-13 |
| 1265418198 | Herbert C Manry | Dentist | 501 Rison St, Stratford Medical Plaza, Danville, VA 24541-2458 | 2005-12-22 |
| Find all providers in DANVILLE | ||||
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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.