Bas W Wafelbakker, DMD

Primary specialty

SpecialistTaxonomy code 174400000X

License

034790 Issued in CA

Practice address

17705 Hale Ave Ste G2
Morgan Hill, CA 95037-4350

Phone

(408) 776-9112

Fax

(408) 776-8141

NPI assigned

Jan 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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 Nov 16, 2015 through Nov 16, 2027

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.

• Wafelbakker Anderson Orthodontics South County

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Morgan Hill, CA
  • NPI 1528361136
  NPD (past) Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487704433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 HALE AVE STE G2",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950374350",
            "telephone_number": "408-776-9112",
            "fax_number": "408-776-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17705 HALE AVE STE G2",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950374350",
            "telephone_number": "408-776-9112",
            "fax_number": "408-776-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAFELBAKKER",
        "first_name": "BAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "034790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Vo
• Frances H Vo
• Steve Vu, PHARMD
• Cha Vue
• Wafelbakker Anderson Orthodontics South County
• Carmen Wah, PHARMD
• Jordan Waite
• Walgreen Co (Walgreens #04516)
• Alayna M Walker
• Shirley Jean Walker

• Specialist in Morgan Hill, CA
• Providers in Morgan Hill, CA by specialty
• Specialist in California

• 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.