Amit Wadke

Primary specialty

Orofacial Pain DentistryTaxonomy code 1223X2210X

License

DE61333205 Issued in WA

Practice address

10025 19TH Ave SE Ste 201
Everett, WA 98208-4275

Phone

(425) 322-1865

NPI assigned

Mar 7, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ofp, TMJ and DSM Specialists

  • Orofacial Pain Dentistry
  • Everett, WA
  • NPI 1306637103
  NPD Authorized official
• Alan D. Erickson, D.D.S., P.S.

  • General Practice Dentistry
  • Arlington, WA
  • NPI 1073954822
  NPD (past)
• Alan D. Erickson, D.D.S., P.S.

  • General Practice Dentistry
  • Redmond, WA
  • NPI 1164234845
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786838400000",
    "number": "1023765393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16212 BOTHELL EVERETT HWY STE F115",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121603",
            "telephone_number": "425-322-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10025 19TH AVE SE STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084275",
            "telephone_number": "425-322-1865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16824 44th Ave W Ste 190",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980373117",
            "country_code": "US",
            "telephone_number": "425-322-1865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADKE",
        "first_name": "AMIT",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2026-08-16",
        "certification_date": "2026-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61333205",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "WA",
            "license": "DE61333205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Tan Vuong, D.D.S.
• Rafael C Wabl, MD
• Jacy Wade
• Kim K Wade
• Ronda Ann Brown Wade, MSN, FNP-BC
• Gina Maria Waggoner, GINA WAGGONER, MAC
• Michele E Wagner, PA-C
• Sara Wagner
• Terry J Wagner, LMP
• Jodi Jean Wagster, LMP

• Orofacial Pain Dentistry in Everett, WA
• Providers in Everett, WA by specialty
• Orofacial Pain Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.