MEDICARE: DR. CHASE WEDEMEIER 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
1	122300000X	Dentist	D011109	AZ

General Provider Information

NPI Number	:	1750953576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHASE WEDEMEIER DDS

Provider Business Mailing Address
First Line	:	2725 E MINE CREEK RD UNIT 1023
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-6258
Country	:	US
Telephone Number	:	319-270-4166
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 N 7TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-5304
Country	:	US
Telephone Number	:	602-910-5700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	08/07/2023

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Directions to “ DR. CHASE WEDEMEIER DDS” Practice Location

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