NPIMap

Individual provider Active NPI

Arnold Richard Wallins, DDS

  • Dentist
  • Peabody, MA
National Provider Identifier
1447235718
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
M11128 Issued in MA
Practice address
765 Lowell St
Peabody, MA 01960-3352
Phone
(978) 535-5090
Fax
(978) 535-5222
NPI assigned
Dec 9, 2005
Last updated
Dec 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X M11128 MA Primary

Addresses

Primary practice location

765 Lowell St
Peabody, MA 01960-3352

Mailing address

50 Salem St a
Lynnfield, MA 01940-2600
Phone (781) 246-2211

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
M11128MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Encompass Health Rehabilitation Hospital of Braintree, LLC Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1447235718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SALEM ST A",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019402600",
            "telephone_number": "781-246-2211",
            "fax_number": "781-246-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 LOWELL ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603352",
            "telephone_number": "978-535-5090",
            "fax_number": "978-535-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLINS",
        "first_name": "ARNOLD",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "M11128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.