Kenneth Ray Wiedenfeld in Victoria - Pediatric Dentistry
Kenneth Ray Wiedenfeld - NPI 1568473189
Kenneth Ray Wiedenfeld is a Pediatric Dentistry in Victoria, Texas. Kenneth Ray Wiedenfeld practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Kenneth Ray Wiedenfeld is 1568473189. The last update date is 2007-07-08.
Kenneth Ray Wiedenfeld's current location address is 101 Professional Park Dr, Victoria, Texas. You can contact this provider via phone number 3615788800 and fax number 3615756986. The mailing address for Kenneth Ray Wiedenfeld is 101 Professional Park Dr, Victoria, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Ray Wiedenfeld |
|---|---|
| Address | 101 Professional Park Dr, Victoria, Texas |
| Phone Number | 3615788800 |
| Fax Number | 3615756986 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1568473189 |
|---|---|
| Provider Enumeration Date | 2006-08-10 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 101 Professional Park Dr |
|---|---|
| City | Victoria |
| State | Texas (TX) |
| Post Code | 779042351 |
| Phone Number | 3615788800 |
| Fax Number | 3615756986 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 14144 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique identifier code issued to Kenneth Ray Wiedenfeld by the Centers for Medicare & Medicaid Services?
The Kenneth Ray Wiedenfeld has been assigned the NPI (National Provider Identifier) 1568473189. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Kenneth Ray Wiedenfeld?
The Kenneth Ray Wiedenfeld is physically situated at 101 Professional Park Dr, in the city of Victoria, state of TX, with the postal code 779042351.
What is Kenneth Ray Wiedenfeld's area of expertise and its corresponding taxonomy classification?
The Kenneth Ray Wiedenfeld's field of specialization is Pediatric Dentistry, and it falls under the taxonomy code 1223P0221X, which categorizes healthcare providers based on their areas of practice.
On what date did the Kenneth Ray Wiedenfeld receive its 1568473189 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Ray Wiedenfeld was assigned its 1568473189 by the Centers for Medicare & Medicaid Services on 2006-08-10.
When was the information regarding Kenneth Ray Wiedenfeld most recently updated?
The details pertaining to the Kenneth Ray Wiedenfeld, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.