Active NPI
Douglas Neil Wade, DDS
- General Practice Dentistry
- Fort Irwin, CA
National Provider Identifier
1649214248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 37033
- Practice address
- 4TH & Inner Loop Road
BLDG. 171,
Fort Irwin, CA 92310-5076 - Phone
- (760) 380-5733
- Fax
- (760) 380-4996
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 37033 | CA | Primary |
Addresses
Primary practice location
4TH & Inner Loop Road
BLDG. 171,
Fort Irwin, CA 92310-5076
Mailing address
BLDG. 171, 4TH & Inner Loop Road
Fort Irwin, CA 92310-5076
Phone (760) 380-5733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37033 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1649214248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLDG. 171, 4TH & INNER LOOP ROAD",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "923105076",
"telephone_number": "760-380-5733",
"fax_number": "760-380-4996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4TH & INNER LOOP ROAD",
"address_2": "BLDG. 171,",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "923105076",
"telephone_number": "760-380-5733",
"fax_number": "760-380-4996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "DOUGLAS",
"middle_name": "NEIL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "37033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.