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NPI Code Detail

MEDICARE: JOHN E WEISE DDS

MEDICARE: JOHN E WEISE DDS
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
11223E0200XEndodontics22D1007546400NJ

General Provider Information

NPI Number : 1710120225
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN E WEISE DDS
Provider Business Mailing Address
First Line : 548 COVINGTON PL
Second Line :
City : WYCKOFF
State : NJ
Zip : 07481-1349
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E RIDGEWOOD AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-3957
Country : US
Telephone Number : 201-447-4404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2009
Last Update Date : 01/11/2026

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Directions to “ JOHN E WEISE DDS” Practice Location

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