Daniel Gerard Walde, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014944 Issued in MO

Practice address

1201 Jefferson St
Suite 220
Washington, MO 63090-4454

Phone

(636) 390-0005

Fax

(636) 390-0001

NPI assigned

Jul 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205856572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 JEFFERSON ST",
            "address_2": "SUITE 220",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904454",
            "telephone_number": "636-390-0005",
            "fax_number": "636-390-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 JEFFERSON ST",
            "address_2": "SUITE 220",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904454",
            "telephone_number": "636-390-0005",
            "fax_number": "636-390-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDE",
        "first_name": "DANIEL",
        "middle_name": "GERARD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Kay Wade, RD, LD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0172)
• Wal-Mart Stores, Inc. (Wal-Mart Vision Center 30-0172)
• Walde Firth Orthodontic Specialists LLP
• Walde Orthodontic Associates DDS PC
• Kevin C Walde, D.D.S., M.S.
• Walgreen Co (Walgreens #05717)
• Janet Kay Walk
• Jennifer Walk, FNP
• Walkenhorst Senior Care, LLC (Home Instead Senior Care)

• General Practice Dentistry in Washington, MO
• Providers in Washington, MO by specialty
• General Practice Dentistry in Missouri

• 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.
• 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.