CARLOS WIESSE DDS PA NPI 1245621523

NPI Information

  • NPI: 1245621523
  • Provider Name: CARLOS WIESSE, DDS, PA
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 5535 LAKE RIDGE PKWY
    GRAND PRAIRIE, TX
    ZIP 75052
  • Phone: (817) 649-8888

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NPI Details

CARLOS WIESSE, DDS, PA is a general practice dentist in Grand Prairie, TX. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CARLOS WIESSE, DDS, PA NPI is 1245621523. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5535 LAKE RIDGE PKWY
GRAND PRAIRIE, TX
ZIP 75052-515
Phone: (817) 649-8888
Fax: (817) 649-8889

The provider's authorized official is Carlos Wiesse .
The authorized official title is Dentist and has the following contact phone number (817) 649-8888.

The enumeration date for this NPI number is 2/9/2015 and was last updated on 2/9/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice15548TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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