Samuel R. Wade, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35629 Issued in TX

Practice address

9901 Valley Ranch Pkwy E Ste 1020
Irving, TX 75063-7179

Phone

(972) 869-5966

NPI assigned

Aug 13, 2019

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

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1508412792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5817 MELSHIRE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302117",
            "telephone_number": "214-906-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 VALLEY RANCH PKWY E STE 1020",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750637179",
            "telephone_number": "972-869-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "SAMUEL",
        "middle_name": "R.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristien Bernadett Vuelvas, P.T.A.
• Nicole Vuong, DC
• VV Pedi Consults PLLC
• Vyttel Inc.
• Lonn March Wade, LLT,MMP
• Sarju Waghela, D.O
• Jane Paula Wagner, MSPT, PCS
• Joni Lynne Wagner, COTA
• Terra Wagner, PHD, LPC-S
• Keith A Waguespack, MD

• General Practice Dentistry in Irving, TX
• Providers in Irving, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.