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Individual
DR. DARRIN MICHAEL WIEDERHOLD
Active
Individual
DR. DARRIN MICHAEL WIEDERHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401414219
VA
1223G0001X
General Practice Dentistry
55531
CA
1223G0001X
General Practice Dentistry
DE61306850
WA
1223G0001X
General Practice Dentistry
DS036972
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401414219
LICENSE
VA
01
—
DE61306850
DENTAL LICENSE
WA
Enumeration date
12/11/2006
Last updated
12/09/2025
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