Provider Demographics
NPI:1811150055
Name:CHLADNY, WESLEY J (DDS, MS)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:J
Last Name:CHLADNY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 RONSTADT RD
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-0620
Mailing Address - Country:US
Mailing Address - Phone:217-840-6271
Mailing Address - Fax:
Practice Address - Street 1:4012 O'HALLORN
Practice Address - Street 2:SUITE B
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179
Practice Address - Country:US
Practice Address - Phone:217-840-6271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0022461223X0400X
TN99461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics