Healthcare Provider Details

I. General information

NPI: 1659390656
Provider Name (Legal Business Name): WIEMEYER DENTISTRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 WASHINGTON ST
DUXBURY MA
02332
US

IV. Provider business mailing address

PO BOX 1687
DUXBURY MA
02331-1687
US

V. Phone/Fax

Practice location:
  • Phone: 781-934-5292
  • Fax: 781-934-3241
Mailing address:
  • Phone: 781-934-5292
  • Fax: 781-934-3241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11664
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number20230
License Number StateMA

VIII. Authorized Official

Name: DR. ANDREW SCOTT WIEMEYER
Title or Position: DENTIST PRESIDENT
Credential: DMD
Phone: 781-934-5292