DR. RUSSELL CONWELL WISMER DDS
NPI 1073685152
Dentist - General Practice in Shawnee, KS
About Dr. Russell Conwell Wismer Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RUSSELL CONWELL WISMER DDS (NPI 1073685152) is an individual general practice provider in Shawnee, Kansas, licensed in Kansas (KS5745) and active in the NPI registry since November 2006. He has opted out of Medicare through December 10, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Russell Conwell Wismer Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 10, 2015 through December 10, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 66216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Russell Wismer's NPI number?
The NPI number for Russell Wismer is 1073685152. It was assigned to this individual provider in the NPPES registry on November 14, 2006.
Where is Russell Wismer located?
Russell Wismer practices at 6301 Pflumm Rd, Shawnee, KS 66216. The listed phone number is (913) 268-7770.
What is Russell Wismer's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Russell Wismer enrolled in Medicare?
No. Russell Wismer has opted out of Medicare through December 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
What insurance does Russell Wismer accept?
Health plans from Humana and Renaissance Dental list Russell Wismer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Russell Wismer was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Russell Conwell Wismer, DDS · NPI 1073685152
General Practice provider in Shawnee, Kansas. Individual provider, active in the CMS NPPES registry since November 14, 2006.
## Identity
- **NPI:** 1073685152 (Entity type: Individual)
- **Enumerated:** November 14, 2006
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** KS5745 (Kansas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6301 PFLUMM RD, Shawnee, KS 66216-2468
- **Phone:** (913) 268-7770
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through December 10, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1073685152) · Data from the CMS NPPES public registry.