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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. NICHOLAS WIESE D.D.S.
NPI 1104814029
Dentist in Faribault, MN

Active since October 13, 2005PECOS Enrolled
417 LINCOLN AVE NW, FARIBAULT, MN 55021(507) 332-7608 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Nicholas Wiese D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICHOLAS WIESE D.D.S. (NPI 1104814029) is an individual dentist in Faribault, Minnesota, licensed in Minnesota (D11401) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104814029
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. NICHOLAS WIESECredential: D.D.S.
Location Address417 LINCOLN AVE NWFaribault, MN 55021-4952
Mailing Address417 Lincoln Ave NwFaribault, MN 55021-4952 · (507) 332-7608
Phone(507) 332-7608
Sole ProprietorNo
Enumeration DateOctober 13, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1104814029 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MN · D11401
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
417 LINCOLN AVE NW, Faribault, MN 55021
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas Wiese D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS BACKENSTOSE
Dentist (General Practice)
417 LINCOLN AVE NW
FARIBAULT, MN 55021
Rice County (507) 332-7608
CHARLES N. MILLER DDS PA
Dentist (General Practice)
417 LINCOLN AVE NW
FARIBAULT, MN 55021
Rice County (507) 332-8888

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 Nicholas Wiese's NPI number?

The NPI number for Nicholas Wiese is 1104814029. It was assigned to this individual provider in the NPPES registry on October 13, 2005.

Where is Nicholas Wiese located?

Nicholas Wiese practices at 417 Lincoln Ave NW, Faribault, MN 55021. The listed phone number is (507) 332-7608.

What is Nicholas Wiese's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Nicholas Wiese enrolled in Medicare?

Yes. Nicholas Wiese is registered in the Medicare PECOS enrollment system.

What insurance does Nicholas Wiese accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 4 other insurers list Nicholas Wiese 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 Nicholas Wiese was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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.