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

Mason P Wistenberg

Individual provider General Practice Dentistry · NPI 1780278283

Mason P Wistenberg is a General Practice Dentistry in Green Bay, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2021.

Licensed in
WI
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

3071 Voyager Dr Ste B
Green Bay, WI 54311-8352
Phone: (920) 465-9887
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 1002699-15 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1780278283
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 24, 2021
Last updated in NPPESAugust 15, 2022
Certification dateAugust 15, 2022
Mailing address481 Saint Marys Blvd, Green Bay, WI 54301-2607

Other providers in Green Bay