Devin Wahlstrom

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

12395 Issued in AZ

Practice address

10603 N Hayden Rd Ste H112
Scottsdale, AZ 85260-5679

Phone

(480) 922-9933

NPI assigned

Aug 18, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 15, 2025 through Sep 15, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wahlstrom Surgical Arts

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Scottsdale, AZ
  • NPI 1720972664

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1740656313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10603 N HAYDEN RD STE H112",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605679",
            "telephone_number": "480-922-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10603 N HAYDEN RD STE H112",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605679",
            "telephone_number": "480-922-9933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2935 Southwest Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sedona",
            "state": "AZ",
            "postal_code": "863363797",
            "country_code": "US",
            "telephone_number": "480-922-9933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2817 Rock Merritt Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283104504",
            "country_code": "US",
            "telephone_number": "910-907-8922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHLSTROM",
        "first_name": "DEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-18",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "37111",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "12395",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OR",
            "license": "10331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophie Wagner, RBT
• Madison Wagoner
• Mona Waheed, IBCLC
• Peyton Wahl
• Wahlstrom Surgical Arts
• Phyllis Waigwa, RN
• Ashley Wain, PDCD
• Thomas Darcy Wais, D.D.S.
• Charles E Wait, DDS
• Kyle Laine Wait, DDS

• Oral & Maxillofacial Surgery (D.M.D.) in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.