Wausa Viking Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WAUSA VIKING INC

Practice address

13822 N 35TH Dr
Ste 1
Phoenix, AZ 85053-5542

Phone

(602) 978-2146

Fax

(602) 978-0640

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David W Banks, GENERAL OFFICE MGR

Title

Secretary for the Corporation

Phone

(602) 955-6000

Specialties & licenses 1

Addresses

Other names 1

• Thunderbird Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randall S Ruminson, DDS

  • Dentist
  • Mesa, AZ
  • NPI 1023179165
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649331786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 E INDIAN SCHOOL ROAD",
            "address_2": "PMB 120 243",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185441",
            "telephone_number": "602-955-6000",
            "fax_number": "602-952-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13822 N 35TH DR",
            "address_2": "STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850535542",
            "telephone_number": "602-978-2146",
            "fax_number": "602-978-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUSA VIKING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SECRETARY FOR THE CORPORATION",
        "authorized_official_telephone_number": "602-955-6000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "GENERAL OFFICE MGR"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thunderbird Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marianne Watts, LPC, LISAC
• Teresa Christine Watts, M.P.T.
• Benjamin Francis Gene Watzig, M.D.
• Gregory Waugh, PSY.D
• Sarah Waugh, RBT
• Erika Wavak, M.D.
• Danielle Lynn Wavra
• Agnieszka Wawerska, D.D.S.
• Antony K Waweru, CRNA
• Karla D Wax, N.P.-C.

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.