Active NPI
Adam Brent Wells, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Diego, CA
National Provider Identifier
1427153642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 57123
- Practice address
- 2634 Escala Cir
San Diego, CA 92108-6720 - Phone
- (502) 548-7118
- Fax
- (502) 852-7163
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8418 | KY | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 57123 | CA | Primary |
Addresses
Primary practice location
2634 Escala Cir
San Diego, CA 92108-6720
Mailing address
2634 Escala Cir
San Diego, CA 92108-6720
Phone (502) 548-7118
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Mar 24, 2016 through Mar 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8418 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smiles Forever Services, LLC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Interoperability endpoints
- awells@direct.westerndental.com
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Duluth, GA
- NPI 1003047499
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215734400000",
"number": "1427153642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2634 ESCALA CIR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921086720",
"telephone_number": "502-548-7118",
"fax_number": "502-852-7163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2634 ESCALA CIR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921086720",
"telephone_number": "502-548-7118",
"fax_number": "502-852-7163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "ADAM",
"middle_name": "BRENT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2008-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "8418",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "57123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.