DR. BRADEN WILDE (NPI# 1780099788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780099788 |
| Entity Type | Individual |
| Full Name | DR. BRADEN WILDE |
| Credential | D.D.S. |
| Practice Address |
52 Medical Group Unit 3690 Apo AE 09126-3690 |
| Practice Telephone | 3144583535 |
| Mailing Telephone | 3144583535 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2018-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D-4592 | ID | Dental Providers |
| Street Address |
52 MEDICAL GROUP UNIT 3690 |
| City | APO |
| State | AE |
| Zip Code | 09126-3690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134619968 | Megan Lynn Davis | Psychologist | 52 Medical Group Unit 3690, Apo, AE 09126-3690 | 2018-05-17 |
| 1518387158 | Brad Pfeifle | Dentist | 52 Medical Group Unit 3690, Apo, AE 09126 | 2014-04-22 |
| 1083955520 | Jessica Defazio | Dentist | 52 Medical Group Unit 3690, Apo, AE 09126 | 2013-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699039990 | Massimiliano Tuveri | Transplant Surgery | Via Delle Rondini 15, Cagliari, CA 09126 | 2012-07-02 |
| 1225326200 | Rachel K Langley | Family Medicine | 52 Medical Group, Unit 3690, Apo, AE 09126 | 2011-07-12 |
| 1548593932 | Morgan Bergman | Counselor | 52 Mdos/sgow, Unit 3690, Apo, AE 09126 | 2009-09-16 |
| 1518192327 | Terry Lynn Johnson | Military Health Care Provider | Spangdahlem Ab, 52 Mdos Unit 3865, Apo, AE 09126 | 2009-05-22 |
| 1649404906 | Matthew James Warters | Military Health Care Provider | 52 Amds Sgpf, Spangdahlem Air Base, RHEINLAND PFALZ 09126 | 2009-05-14 |
| 1619141686 | Donna Marie Burrowes | Counselor | 52 Mdg Unit 3690, Apo, AE 09126 | 2008-04-21 |
| 1962619296 | Katie M Ragan | Psychologist | 52 Mdos/sgot, Unit 3690, Apo, AE 09126 | 2007-05-17 |
| 1043426463 | Sylvia Jean Ringen | Social Worker | Psc 9 Unit 3690, 52 Mdos/sgohf, Apo, AE 09126 | 2007-05-15 |
| 1225189319 | Andrea L Loudermilk-shull | Speech-Language Pathologist | 52 Mdos/sgov, Unit 3690, Apo, AE 09126 | 2007-01-15 |
| 1013083005 | David Max Jones | Dentist | 52 Ds/cc, Unit 3866, Apo, AE 09126 | 2006-11-28 |
| Find all providers in zip 09126 | ||||
| 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 |
|---|---|---|---|---|
| 1154938520 | Jacob Steven Blackhurst | Dentist | Bldg 4-1838 Normandy Dr, Apo, AA 28307-7302 | 2020-09-29 |
| 1669088852 | Matthew Dejong | Dentist | Kleber Dental Clinic, Bldg 3287, Apo, AE 09227 | 2020-09-22 |
| 1184236895 | Christina Belousov | Dentist | 14351 Battalion Ave, Apo, AA 76544 | 2020-08-24 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1659927937 | Benjamin Kyunghan Yoon | Dentist | 618th Dental Company, Carius Dental Clinic Unit #15652, Attn: Credentails Coordinator, Apo, AP 96271-5245 | 2019-08-13 |
| 1477108967 | Shane Clay Hoffner | Dentist | 618th Dental Co, Carius Dental Clinic Bldg# P3020, Attn: Credentials Office, Apo, AP 96271-5245 | 2019-08-02 |
| 1740848449 | Samuel Kong Hmong Lo | Dentist | Carius Dental Clinic, Unit 15652, Apo, AP 96271 | 2019-05-29 |
| 1437712130 | Andrea Rose Deese | Dentist | Raf Lakenheath 48 Mdg / Sghc, Unit 5115, Apo, AE 09461-5115 | 2019-04-17 |
| 1871052837 | Ryan Kenny Zarnowski | Dentist | 673 Mdg, 5955 Zeamer Avenue, Jber, Ak 99506, Apo, AA 99506 | 2019-03-18 |
| 1619440922 | Joo Park | Dentist | Cmr 402 Unit 33301, Apo, AE 09180 | 2019-01-09 |
| Find all providers in APO | ||||
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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.