John Stanford Wakeman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00009436 Issued in WA

Practice address

278 A St
Suite 1
Friday Harbor, WA 98250-7178

Phone

(360) 378-5580

Fax

(360) 378-5619

NPI assigned

May 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Arts

  • General Practice Dentistry
  • Friday Harbor, WA
  • NPI 1790138634
  NPD (past) Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467666990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 A ST",
            "address_2": "SUITE 1",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982507178",
            "telephone_number": "360-378-5580",
            "fax_number": "360-378-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 A ST",
            "address_2": "SUITE 1",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982507178",
            "telephone_number": "360-378-5580",
            "fax_number": "360-378-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEMAN",
        "first_name": "JOHN",
        "middle_name": "STANFORD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Richard Uri III, CDPT
• Donna Marie Vaughan, M.S., R.D., IBCLC
• Stacie Marie Vilendrer, M.D.
• Village at Home
• Village at the Harbor
• Lauren Wall, RN, IBCLC
• Washington Institute of Natural Sciences (W.I.N.S. Integrated Medical Clinic)
• Gary Waters, LCSW, LMFT, LADC
• Bonita Wegenast, LMP
• Inge M. Wendelberger, M.A., CDPT

• General Practice Dentistry in Friday Harbor, WA
• Providers in Friday Harbor, WA by specialty
• General Practice Dentistry in Washington

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.