Individual provider Active NPI

David Wilson Wardlaw, ORTHODONTIST

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Little Rock, AR
National Provider Identifier
1386704385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2815 Issued in AR
Practice address
8315 Cantrell Road
Suite 100
Little Rock, AR 72227
Phone
(501) 227-5757
Fax
(501) 227-0139
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2815 AR Primary

Addresses

Primary practice location

8315 Cantrell Road
Suite 100
Little Rock, AR 72227

Mailing address

8315 Cantrell Road
Suite 100
Little Rock, AR 72227
Phone (501) 227-5757

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

State licenses

LicenseStateTypeSpecialty
2815ARMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wardlaw Orthodontics, P.a. Orthodontics and Dentofacial Orthopedics PastSince Jun 14, 2020 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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386704385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 CANTRELL ROAD",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72227",
            "telephone_number": "501-227-5757",
            "fax_number": "501-227-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8315 CANTRELL ROAD",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72227",
            "telephone_number": "501-227-5757",
            "fax_number": "501-227-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDLAW",
        "first_name": "DAVID",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "ORTHODONTIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AR",
            "license": "2815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

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

Verify at the official NPI Registry.