Individual provider Active NPI

Robert Thomas Wade, MS, DDS

  • Pediatric Dentistry
  • Waukee, IA
National Provider Identifier
1306834049
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DDS-07997 Issued in IA
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

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
124456IAMDMental Health Counselor
DDS-07997IAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Walnut Hills Pediatric Dentistry, L.L.C. Pediatric Dentistry PastSince May 4, 2025 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.

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.

Verify at the official NPI Registry.