Kristin Melissa Wade, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7822 Issued in AZ

Practice address

409 W Main St
Payson, AZ 85541-5487

Phone

(928) 472-8400

NPI assigned

Jul 7, 2009

Sex

Female

Sole proprietor

No

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 AZ

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

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.

• Kristin M Wade DMD PLLC

  • General Practice Dentistry
  • Payson, AZ
  • NPI 1700279437
  NPD (past) Authorized official
• Desert Dentistry, PLLC

  • General Practice Dentistry
  • Payson, AZ
  • NPI 1558685933
  NPD (past)

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1245469733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W MAIN ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415487",
            "telephone_number": "928-472-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W MAIN ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415487",
            "telephone_number": "928-472-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "KRISTIN",
        "middle_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Rolf Veenstra, M.D.
• VHS Arizona Heart Institute Inc
• Lynne A Vigil, N.P.
• Lauren Marie Vlahopoulos
• Darrell D Wadas, MD
• Frank Edward Waechter III, MD
• Walgreen Co
• Walmart Inc.
• Walmart Stores, Inc.
• Lauren Washatka, MD

• General Practice Dentistry in Payson, AZ
• Providers in Payson, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.