Active NPI
Robert Thomas Wade, MS, DDS
- Pediatric Dentistry
- Waukee, IA
National Provider Identifier
1306834049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DDS-07997
- Practice address
- 64 E Hickman Rd
Waukee, IA 50263-5011 - Phone
- (515) 987-1155
- Fax
- (515) 987-1181
- NPI assigned
- Oct 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 124456 | IA | |
| Pediatric Dentistry | 1223P0221X | DDS-07997 | IA | Primary |
Addresses
Primary practice location
64 E Hickman Rd
Waukee, IA 50263-5011
Mailing address
64 E Hickman Rd
Waukee, IA 50263-5011
Phone (515) 987-5115
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124456 | IA | MD | Mental Health Counselor |
| DDS-07997 | IA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walnut Hills Pediatric Dentistry, L.L.C. | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Waukee, IA
- NPI 1326343252
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1306834049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 E HICKMAN RD",
"city": "WAUKEE",
"state": "IA",
"postal_code": "502635011",
"telephone_number": "515-987-5115",
"fax_number": "515-987-1181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 E HICKMAN RD",
"city": "WAUKEE",
"state": "IA",
"postal_code": "502635011",
"telephone_number": "515-987-1155",
"fax_number": "515-987-1181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "ROBERT",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "MS, DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "124456",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IA",
"license": "DDS-07997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waukee, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.