Provider Demographics
NPI:1750502381
Name:WHEELER, JON PEYTON (DDS)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:PEYTON
Last Name:WHEELER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 STERLING RIDGE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2746
Mailing Address - Country:US
Mailing Address - Phone:281-681-9880
Mailing Address - Fax:281-681-9543
Practice Address - Street 1:6707 STERLING RIDGE DR
Practice Address - Street 2:SUITE F
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2746
Practice Address - Country:US
Practice Address - Phone:281-681-9880
Practice Address - Fax:281-681-9543
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX197751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry