Mitchell Dean Waller, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8330 Issued in AZ

Practice address

5931 W Hedgehog PL # B105
Phoenix, AZ 85083-6559

Phone

(309) 255-2905

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Estrella Pkwy Medical Center, LLC.

  • Medical Physician Assistant
  • Goodyear, AZ
  • NPI 1871546036

  Chiropractor

  Medicare reassignment NPD
• Hope Diabetes Center, LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1104865757
  Medicare reassignment NPD
• I Am Wellness Az LLC

  • Adult Medicine Physician
  • Chandler, AZ
  • NPI 1184354532
  Medicare reassignment NPD
• Maria Gonzalez Berlari, MD LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1699025981
  Medicare reassignment NPD
• Michael F Esber DPM PC

  • Foot Surgery Podiatrist
  • Sun City West, AZ
  • NPI 1902907504
  Medicare reassignment NPD
• Progressive Pain Management Inc

  • Interventional Pain Medicine Physician
  • Casa Grande, AZ
  • NPI 1881866754
  Medicare reassignment NPD
• Advanced Minimally Invasive Surgical

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1295056919
  Medicare reassignment
• Chiropractic Solutions, Inc

  • Chiropractor
  • Gilbert, AZ
  • NPI 1881080208
  NPD (past) Authorized official
• Bmi423I

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1407683162
  NPD
• Pridemore Chiropractic Center, Inc

  • Chiropractor
  • Macomb, IL
  • NPI 1215010673
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772323200000",
    "number": "1457424467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5931 W HEDGEHOG PL # B105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850836559",
            "telephone_number": "309-255-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5931 W HEDGEHOG PL # B105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850836559",
            "telephone_number": "309-255-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "MITCHELL",
        "middle_name": "DEAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2026-03-01",
        "certification_date": "2026-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8330",
            "primary": true
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "AZ",
            "license": "8330",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05527512",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney L Wallace, LAC
• Taffy Wallace
• Jessica Anne Waller
• Kara Waller
• Marguerite Waller, RBT
• Karen Wallerich
• Curtis Craig Walling, PHD
• Jeffrey Wayne Walling, PHARM D.
• Monique Wallis, M.S., CCC-SLP
• Andrew Caswell Wallmann, M.D.

• Chiropractor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.