Chandur PK Wadhwani, DDS, MSD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DE00010028 Issued in WA

Practice address

12715 Bel-Red Rd.
Suite 201
Bellevue, WA 98005-2627

Phone

(425) 453-1117

Fax

(425) 462-1878

NPI assigned

Nov 14, 2006

Last updated

May 18, 2016By the provider in NPPES

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

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1689746711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12715 BEL-RED RD",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052627",
            "telephone_number": "425-453-1117",
            "fax_number": "425-462-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12715 BEL-RED RD.",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052627",
            "telephone_number": "425-453-1117",
            "fax_number": "425-462-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADHWANI",
        "first_name": "CHANDUR",
        "middle_name": "PK",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "10028",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE00010028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Long Vu
• Tung Thanh Vu, DDS
• Washington Vu
• Blake Wachi, M.D.
• Neil H. Waddington, M.D.
• Evonne Wagner - Sears, SOTP
• Nancy Michele Wagner, ARNP
• Randee Michelle Wagner, M.ED, BCBA
• Cailen Ahmed Wahan
• Marianne Hanna Wahba, PA-C

• Prosthodontics in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Prosthodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.