Robert Wade Ferrell, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

350703 Issued in UT

Practice address

619 N 500 W
Provo, UT 84601-1547

Phone

(801) 374-8002

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

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  • NPI 1063093722
  NPD (past)
• Callaway-Nelson Lemmon Valley Dental Group PC

  • General Practice Dentistry
  • Irvine, CA
  • NPI 1447636378
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1548330004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 E SKYLINE DR",
            "address_2": "SUITE #300",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054846",
            "telephone_number": "801-334-9258",
            "fax_number": "801-334-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011547",
            "telephone_number": "801-374-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Vista Knoll Pkwy Ste 114",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895065649",
            "country_code": "US",
            "telephone_number": "775-971-9282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRELL",
        "first_name": "ROBERT",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "350703",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NV",
            "license": "S4-138C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliann Fenn
• Jo Kathryn Fenstermaker
• Jessyca Fernandes de Souza
• Kerry Alice Fernandez
• Nicole Fernandez
• Jessica April Ferry
• McKell Ferry, PHARMD
• Rachel Lynne Ferry
• Shaun Fesler
• Shae Fetters, CFA

• Periodontics in Provo, UT
• Providers in Provo, UT by specialty
• Periodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.