Matthew Walla, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

055170 Issued in NY

Practice address

3985 Main St
Amherst, NY 14226-3404

Phone

(716) 832-1550

NPI assigned

Aug 18, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Laurence C. Wright, D.D.S., P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Amherst, NY
  • NPI 1295826634
  NPD (past)
• Matthew Walla DDS PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Amherst, NY
  • NPI 1164100855
  NPD (past)

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1316227606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 MAIN ST",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142263404",
            "telephone_number": "716-832-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 MAIN ST",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142263404",
            "telephone_number": "716-832-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLA",
        "first_name": "MATTHEW",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "055170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Rose Marie Wales
• Walgreen Co (Walgreens #05610)
• Walgreen Co (Walgreens #12408)
• Walgreen Eastern Co Inc (Walgreens #03267)
• Ian Jacob Walker, DDS
• Judy C Wallace, M.S.,SP.ED,LIT
• Matthew Walling, DC
• Erin Walsh, RPH
• Matthew R Walsh, PT
• Stacey Walsh

• Orthodontics and Dentofacial Orthopedics Dentistry in Amherst, NY
• Providers in Amherst, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.