Wade Kifer, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

3468 Issued in AR

Practice address

1845 N Green Acres Rd
Fayetteville, AR 72703-2615

Phone

(479) 521-2112

NPI assigned

Jan 9, 2007

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

Other identifiers 2

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 Feb 11, 2016 through Feb 11, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447309364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032615",
            "telephone_number": "479-521-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032615",
            "telephone_number": "479-521-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIFER",
        "first_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA INS, AND LICENSE #",
            "identifier": "3468",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5 Y 371",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melvin Khanga, MHPP/AT/ YCW
• Brittney Sengchan Khounborine, QBHP
• Kids Unlimited Learning Academy of Fayetteville
• Kids Unlimited Learning Academy of Fayetteville
• Claire Elizabeth Kifer, P.T.
• Navin R Kilambi, MD
• Nirmal K Kilambi, M.D.
• John Kilcrease
• Kristen L Kilgore, PHARMD
• Nicholas Killingsworth, B.A.

• Dentist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Dentist in Arkansas

• 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.