Antoine E Wakim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6078 Issued in KS

Practice address

710 N Woodchuck
Wichita, KS 67212

Phone

(316) 721-4477

Fax

(310) 721-4099

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Antoine E Wakim DDS PA

  • Dentist
  • Wichita, KS
  • NPI 1780721134
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1487746574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N WOODCHUCK",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-721-4477",
            "fax_number": "310-721-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N WOODCHUCK",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-721-4477",
            "fax_number": "310-721-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKIM",
        "first_name": "ANTOINE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6078",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "6078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100223080A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali Elaine Wait, M.D.
• Mary J Wait, ARNP
• Elizabeth Waite
• Alexis Wakeham, PTA
• Christina Marie Wakeman, LAC-ST
• Wal-Mart Pharmacy
• Wal-Mart Store, Inc.
• Wal-Mart Stores Inc
• Wal-Mart Stores, Inc.
• Wal-Mart Stores, Inc.

• Dentist in Wichita, KS
• Providers in Wichita, KS by specialty
• Dentist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.