Wayne Eugene Walcott, DDS MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11148 Issued in MI

Practice address

1910 Packard St
Ann Arbor, MI 48104-4734

Phone

(734) 994-3700

Fax

(734) 994-3704

NPI assigned

May 2, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1033177027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044734",
            "telephone_number": "734-994-3700",
            "fax_number": "734-994-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044734",
            "telephone_number": "734-994-3700",
            "fax_number": "734-994-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCOTT",
        "first_name": "WAYNE",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1533980",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas W Wakefield, MD
• Kimberly Walainis, PT, DPT
• Annette Walblay, N.P.
• Carolyn Forbes Walborn, RN,MS,CPNP
• Brett J Walcott, D.D.S.
• Walcottdental, PLC
• Crytal Walcutt
• Erica Wald, R.D.
• Jerry Samuel Walden, M.D.
• Julie A Walden, LMSW

• General Practice Dentistry in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.