Carter Milan Waller, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410947 Issued in VA

Practice address

1417 Parcell St
Fredericksburg, VA 22401-4616

Phone

(540) 899-1777

Fax

(540) 899-2266

NPI assigned

Mar 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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.

• Big Smile Dental

  • Dental Clinic/Center
  • Fredericksburg, VA
  • NPI 1902329329
  NPD Authorized official
• Bigsmile Inc.

  • Dental Clinic/Center
  • Fredericksburg, VA
  • NPI 1316700115
  NPD Authorized official
• Dedicated Dental PLLC

  • Dental Clinic/Center
  • Stafford, VA
  • NPI 1700469103
  NPD Authorized official

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1407098197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 PARCELL ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014616",
            "telephone_number": "540-899-1777",
            "fax_number": "540-899-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 PARCELL ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014616",
            "telephone_number": "540-899-1777",
            "fax_number": "540-899-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "CARTER",
        "middle_name": "MILAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "15251",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Wallace
• Joey Andrew Wallace
• John Kline Wallace, DDS
• Lindsay Cole Wallace
• Vicki Wallace, NP
• Leah Waller, PA-C
• Susan J Walley
• Michelle Walraven, CPHT
• Edward Gilbert Walsh, MD
• Gabrielle Walsh

• General Practice Dentistry in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.