Provider Demographics
NPI:1801504659
Name:JON P. WHEELER, DDS, PA
Entity type:Organization
Organization Name:JON P. WHEELER, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:P
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:281-681-9880
Mailing Address - Street 1:6707 STERLING RIDGE DR STE F
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2773
Mailing Address - Country:US
Mailing Address - Phone:281-681-9880
Mailing Address - Fax:
Practice Address - Street 1:19077 CHAMPION FOREST DR STE A
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8516
Practice Address - Country:US
Practice Address - Phone:832-761-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty