Glenn John Wisnieski, DDS is a medicare enrolled "Dentist - General Practice" provider in Walkerton, Indiana. His current practice location is
409 Roosevelt Rd, Walkerton, Indiana. You can reach out to his office (for appointments etc.) via phone at
(574) 586-3242.
Glenn John Wisnieski is licensed to practice in Indiana (license number 12007003A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1275658056.
Healthcare Provider's Profile
Full Name | Glenn John Wisnieski |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 409 Roosevelt Rd, Walkerton, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1275658056
- Provider Enumeration Date: 03/20/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 9931404068
- Enrollment ID: I20160226000975
Medical Identifiers
Medical identifiers for Glenn John Wisnieski such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275658056 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 12007003A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glenn John Wisnieski is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Glenn John Wisnieski, DDS 409 Roosevelt Rd, Walkerton, IN 46574 Ph: (574) 586-3242 | Glenn John Wisnieski, DDS 409 Roosevelt Rd, Walkerton, IN 46574 Ph: (574) 586-3242 |
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