Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Michael J Wine, DDS

Individual provider Dentist · NPI 1245353168

Dr. Michael J Wine, DDS is a Dentist in Jackson, Wyoming. Licensed in Idaho and Wyoming. Registered with an NPI since 2007.

Licensed in
ID, WY
In the registry since
2007
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

610 W Broadway Ave
Jackson, WY 83001-8213
Phone: (307) 732-2273
Fax: (307) 732-1660
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 1325 (WY)
Dentist Taxonomy 122300000X · Licence D 4424 (ID)

Record details

NPI number1245353168
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 7, 2007
Last updated in NPPESSeptember 1, 2016
Mailing address6797 Shire Ridge Dr, Victor, ID 83455-5036

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