WILKIE J STADEKER (NPI# 1952523623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952523623 |
| Entity Type | Individual |
| Full Name | WILKIE J STADEKER |
| Credential | DDS |
| Practice Address |
123 Marble Mill Rd Nw Suite B Marietta GA 30060-7954 |
| Practice Telephone | 6783545119 |
| Practice Fax Number | 6783545191 |
| Mailing Telephone | 6783545119 |
| Mailing Fax Number | 6783545191 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
011447 | GA | Dental Providers |
| Street Address |
123 MARBLE MILL RD NW SUITE B |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-7954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144435900 | Karen Renee Mills | Dentist | 123 Marble Mill Rd Nw, Suite A, Marietta, GA 30060-7954 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| 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 |
|---|---|---|---|---|
| 1912157355 | Ranjitha Krishna | Dentist | 810 Canton Rd Ne Ste B, Marietta, GA 30060-7257 | 2008-09-23 |
| 1992847610 | Susan Alexander, Dmd, PC | Dentist | 3020 Roswell Rd Ste 130, Marietta, GA 30062-4987 | 2007-02-12 |
| 1982798716 | Peter Clifford Shatz | Dentist | 611 Campbell Hill St Nw, Suite 102, Marietta, GA 30060-1386 | 2006-10-03 |
| 1477574994 | Drs. Silver and Tomaselli, P.C. | Dentist | 810 Canton Rd Ne, Suite B, Marietta, GA 30060-7257 | 2006-07-21 |
| 1245257898 | Husam Mohamad Bezreh | Dentist | 1505 Johnson Ferry Road, Suite 100, Marietta, GA 30062-6508 | 2006-07-17 |
| 1316243389 | Kennestone Periodontics of Marietta, PC | Dentist | 611 Campbell Hill St Nw, Suite 102, Marietta, GA 30060-1386 | 2011-02-08 |
| 1104084235 | Susan Patricia Alexander | Dentist | 3020 Roswell Rd Ste 130, Marietta, GA 30062-4987 | 2008-05-27 |
| 1265553614 | Martin Silver | Dentist | 810 Canton Rd Ne, Suite B, Marietta, GA 30060-7257 | 2007-04-03 |
| 1801942347 | Larry Sweeting | Dentist | 1275 Powers Ferry Rd Se, Marietta, GA 30067-9486 | 2007-01-26 |
| 1346312071 | William B. Webster, Jr., Dds, PC | Dentist | 1225 Johnson Ferry Rd, Suite 760, Marietta, GA 30068-2727 | 2006-11-15 |
| Find all providers in MARIETTA | ||||
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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.