Provider Demographics
NPI:1891856217
Name:WINGET, WILLIAM JAMES (DDS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JAMES
Last Name:WINGET
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 1:7420 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:LAKEVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48850
Mailing Address - Country:US
Mailing Address - Phone:989-352-1364
Mailing Address - Fax:
Practice Address - Street 1:924 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:MI
Practice Address - Zip Code:48850
Practice Address - Country:US
Practice Address - Phone:989-352-7294
Practice Address - Fax:989-352-8348
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI18409122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID184090OtherBCBS DENTAL
MI1955910090OtherBCBS MEDICAL
#36043OtherUNITED CONCORDIA PROV
#36043OtherUNITED CONCORDIA PROV
MI1955910090OtherBCBS MEDICAL
MIP04500002Medicare ID - Type Unspecified