Individual provider Active NPI

David Alec Waldron, DDS

  • Dentist
  • Cuyahoga Falls, OH
National Provider Identifier
1063556314
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14993 Issued in OH
Practice address
802 Graham Rd
Cuyahoga Falls, OH 44221-1049
Phone
(330) 929-7344
Fax
(330) 929-4465
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14993 OH Primary

Addresses

Primary practice location

802 Graham Rd
Cuyahoga Falls, OH 44221-1049

Mailing address

802 Graham Rd
Cuyahoga Falls, OH 44221-1049
Phone (330) 929-7344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14993OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063556314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211049",
            "telephone_number": "330-929-7344",
            "fax_number": "330-929-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211049",
            "telephone_number": "330-929-7344",
            "fax_number": "330-929-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "DAVID",
        "middle_name": "ALEC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "14993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.