Healthcare Provider Details

I. General information

NPI: 1003370750
Provider Name (Legal Business Name): PIERRE LOUIS AUGUSTE WOHLGEMUTH D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13065 E 17TH AVE FL 1
AURORA CO
80045-2532
US

IV. Provider business mailing address

801 S CHERRY ST APT 383
GLENDALE CO
80246-2720
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-5505
  • Fax:
Mailing address:
  • Phone: 646-535-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0401417396
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDEN.00206408
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number37237
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number000119
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: