Serv Wahan, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE00010517 Issued in WA

Practice address

7021 117TH PL NE
Kirkland, WA 98033-8461

Phone

(425) 890-8424

Fax

(425) 822-0739

NPI assigned

Jul 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 9, 2012 through May 9, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kincaid, McClary & Kim D.D.S, P.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Arlington, WA
  • NPI 1043267925
  NPD (past)

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376564229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7021 117TH PL NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338461",
            "telephone_number": "425-890-8424",
            "fax_number": "425-822-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7021 117TH PL NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338461",
            "telephone_number": "425-890-8424",
            "fax_number": "425-822-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHAN",
        "first_name": "SERV",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00010517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Bao Thi Vu, DDS
• W3 Clinics PLLC (Work Well Clinics)
• Amelia Wachtel, OT
• Alyssa Wagner
• Jill Francene Wagner, PT
• David V Wahl, MD
• Shannon Walden, LMT
• Rylie Alexander Wales, DC
• Walgreen Co (Walgreens #06258)
• Walgreen Co (Walgreens #04156)

• Oral and Maxillofacial Surgery (Dentist) in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.