Wiens, Jonathan P

Wiens, Jonathan P is an individual health care provider with primary practice located at 6177 Orchard Lake Road Suite 120, West Bloomfield MI 48322. He recently has 4 registered licenses in different health care specialties including Dental Providers / Dentist, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Prosthodontics. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Wiens, Jonathan P can be contacted via phone (248) 855-6655.

Contact Information

Primary practice address
6177 Orchard Lake Road Suite 120 West Bloomfield MI 48322
Phone: (248) 855-6655
Fax: (248) 855-0803
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D10587 Michigan
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 2901010587 Michigan
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 2901010587 Michigan
Dental Providers / Prosthodontics 1223P0700X 2901010587 Michigan

Profile Details

NPI number 1497894596
LBN Legal business name Wiens, Jonathan P
Credentials DDS MSD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jul 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497894596 NPPES
Michigan MEDICAID 1940814

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