WDWROSEVILLEPLLC (NPI# 1659936441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659936441 |
| Entity Type | Organization |
| Organization Name | WDWROSEVILLEPLLC |
| Practice Address |
21055 E 12 Mile Rd Roseville MI 48066-2205 |
| Practice Telephone | 5867720100 |
| Practice Fax Number | 5867723128 |
| Mailing Telephone | 5867720100 |
| Mailing Fax Number | 5867723128 |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-05-07 |
| Authorized Official Name | DR. WHITNEY WEINER (OWNER) |
| Authorized Official Telephone | 5867720100 |
| Is Organization Subpart | Y |
| Parent Organization Name | WDW VENTURES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
Dental Providers | ||
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Whole Dental Wellness | Doing Business As Name - Organization |
| Street Address |
21055 E 12 MILE RD |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-2205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114193208 | Carl Papa D.d.s., P.C. | Dentist | 21055 E 12 Mile Rd, Roseville, MI 48066-2205 | 2008-05-08 |
| 1174184055 | James Emmanuel Tangalos | Dentist | 21055 E 12 Mile Rd, Roseville, MI 48066-2205 | 2019-06-22 |
| 1518352145 | Natasha Aazami | Dentist | 21055 E 12 Mile Rd, Roseville, MI 48066-2205 | 2015-03-31 |
| 1003229733 | Shahrzad Orenduff | Dentist | 21055 E 12 Mile Rd, Roseville, MI 48066-2205 | 2014-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639569684 | Divine Family Denistry | Dentist | 27845 Gratiot Ave, Roseville, MI 48066-4848 | 2015-01-29 |
| 1114130788 | Key Soon Hu Choi | Dentist | 3224 Corniche Ln, Roseville, CA 95661-3967 | 2007-05-08 |
| 1902951064 | Dean Nadeem Ahmad | Dentist | 580 N Sunrise Ave Ste 190, Roseville, CA 95661-3035 | 2007-01-25 |
| 1073660346 | Jennifer Goss | Dentist | 125 Ascot Drive, Suite A, Roseville, CA 95661-3408 | 2007-01-05 |
| 1477961738 | Joohyun Cha | Dentist | 10357 Fairway Dr Ste 100, Roseville, CA 95678-3544 | 2014-07-30 |
| 1235321852 | Capitol Periodontal Group | Dentist | 2428 Professional Dr, Ste 100, Roseville, CA 95661-7774 | 2007-08-16 |
| 1285852194 | Louis Gene Cuccia | Dentist | 125 Ascot Dr, Suite A, Roseville, CA 95661-3408 | 2007-04-23 |
| 1619000478 | Asvin Vidyacharan Vasanthan | Dentist | 1420 E Roseville Pkwy, #230, Roseville, CA 95661-3078 | 2007-03-13 |
| 1659406205 | Rosemary Wu | Dentist | 2428 Professional Dr, Ste. 100, Roseville, CA 95661-7774 | 2007-02-23 |
| 1598810004 | Nicky M Hakimi Dds Inc | Dentist | 1420 E Roseville Pkwy, Suite 230, Roseville, CA 95661-3078 | 2007-01-24 |
| Find all providers in ROSEVILLE | ||||
Please comment or provide details below to improve the information on WDWROSEVILLEPLLC.
| 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.