Provider Demographics
NPI:1275320442
Name:WIELAND ORTHODONTICS, PLLC
Entity type:Organization
Organization Name:WIELAND ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:WIELAND
Authorized Official - Suffix:
Authorized Official - Credentials:BA, DDS, MS
Authorized Official - Phone:309-721-2451
Mailing Address - Street 1:3800 ARCHER DR
Mailing Address - Street 2:
Mailing Address - City:EAST MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61244-3757
Mailing Address - Country:US
Mailing Address - Phone:309-721-2451
Mailing Address - Fax:
Practice Address - Street 1:3800 ARCHER DR
Practice Address - Street 2:
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-3757
Practice Address - Country:US
Practice Address - Phone:309-721-2451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental