DR. JOHN D WIEBE (NPI# 1811037385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811037385 |
| Entity Type | Individual |
| Full Name | DR. JOHN D WIEBE |
| Credential | DDS |
| Practice Address |
4815 Paulsen St Savannah GA 31405-4418 |
| Practice Telephone | 9123522324 |
| Practice Fax Number | 9123540935 |
| Mailing Telephone | 9123522324 |
| Mailing Fax Number | 9123540935 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2009-03-04 |
| 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 |
DN009669 | GA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SOUTH CAROLINA | ZZ9669 | 01 |
| GA | 02643168 | 05 | |
| GA | DORAL DENTAL MEDICAID | 9183964 | 01 |
| Street Address |
4815 PAULSEN ST |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518971969 | Clifford Jens Berger | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2006-07-28 |
| 1932330164 | Justin Brian Damron | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2009-08-05 |
| 1801920301 | Southeastern Oral and Maxillofacial Surgical Associates P.C. | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-03-15 |
| 1972643476 | Jennifer E Hall | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| 1255471769 | George B Massey | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| 1295875755 | Alfred E Pesto Jr. | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| 1124168612 | William R Massey | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| 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 |
|---|---|---|---|---|
| 1346337359 | Daniel Steven Carson Jr. | Dentist | 6602 Abercorn St, Savannah, GA 31405-5848 | 2006-10-10 |
| 1518971969 | Clifford Jens Berger | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2006-07-28 |
| 1235361908 | Jackson P. Morgan, IIi, PC | Dentist | 4700 Waters Ave, Suite 504, Savannah, GA 31404-6220 | 2009-08-14 |
| 1932330164 | Justin Brian Damron | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2009-08-05 |
| 1841415874 | Chatham Oral Surgery, PC | Dentist | 4849 Paulsen St, Savannah, GA 31405-4423 | 2007-04-16 |
| 1801920301 | Southeastern Oral and Maxillofacial Surgical Associates P.C. | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-03-15 |
| 1972643476 | Jennifer E Hall | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| 1255471769 | George B Massey | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| 1295875755 | Alfred E Pesto Jr. | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| 1124168612 | William R Massey | Dentist | 4815 Paulsen St, Savannah, GA 31405-4418 | 2007-02-07 |
| Find all providers in SAVANNAH | ||||
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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.