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

Dr. Trystan Richard Wiedow, DDS

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1427639038

Dr. Trystan Richard Wiedow, DDS is an Oral and Maxillofacial Surgery (Dentist) in Green Bay, Wisconsin. Licensed in Iowa and Wisconsin. Registered with an NPI since 2021.

Licensed in
IA, WI
In the registry since
2021
Specialties on file
3
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

2353 S Ridge Rd
Green Bay, WI 54304-5857
Phone: (920) 499-0471
Show map & directions

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

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 1002773-15 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 1002773 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence RES-30614 (IA)

Record details

NPI number1427639038
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 15, 2021
Last updated in NPPESJune 20, 2026
Certification dateJune 20, 2026

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