Provider Demographics
NPI:1447333414
Name:LANDWEHR, DAVID JOHN (DDS MS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:LANDWEHR
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 CROSSROADS DR STE 2900
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-2425
Mailing Address - Country:US
Mailing Address - Phone:608-442-3300
Mailing Address - Fax:
Practice Address - Street 1:2418 CROSSROADS DR STE 2900
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-2425
Practice Address - Country:US
Practice Address - Phone:608-442-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51200151223P0106X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology