MEDICARE: WHEELER FAMILY DENTISTRY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8107	KY

General Provider Information

NPI Number	:	1528119914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHEELER FAMILY DENTISTRY, PLLC

Provider Business Mailing Address
First Line	:	255 PARAQUET SPRINGS DR
Second Line	:
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-6007
Country	:	US
Telephone Number	:	502-543-2123
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 PARAQUET SPRINGS DR
Second Line	:
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-6007
Country	:	US
Telephone Number	:	502-543-2123
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS WHEELER
Credential	:	D.M.D.
Telephone Number	:	502-543-2123

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	08/22/2020

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