Organization Active NPI

Wafelbakker Anderson Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Walnut Creek, CA
National Provider Identifier
1740694181
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
WAFELBAKKER ANDERSON ORTHODONTICS
Practice address
1855 San Miguel Dr
Ste 33
Walnut Creek, CA 94596-5279
Phone
(925) 935-5630
Fax
(925) 934-8130
NPI assigned
Jun 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Authorized official

Name
Dr. Bas Willem Wafelbakker, DMD
Title
President
Phone
(925) 935-5630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X CA Primary

Addresses

Primary practice location

1855 San Miguel Dr
Ste 33
Walnut Creek, CA 94596-5279

Mailing address

1855 San Miguel Dr
Ste 33
Walnut Creek, CA 94596-5279
Phone (925) 935-5630

National Provider Directory

National Provider Directory

Locations

1855 San Miguel Dr
Ste 33
Walnut Creek, CA 94596
Phone (925) 935-5630

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402617600000",
    "number": "1740694181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SAN MIGUEL DR",
            "address_2": "STE 33",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965279",
            "telephone_number": "925-935-5630",
            "fax_number": "925-934-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 SAN MIGUEL DR",
            "address_2": "STE 33",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965279",
            "telephone_number": "925-935-5630",
            "fax_number": "925-934-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAFELBAKKER ANDERSON ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-13",
        "last_updated": "2014-06-13",
        "status": "A",
        "authorized_official_last_name": "WAFELBAKKER",
        "authorized_official_first_name": "BAS",
        "authorized_official_middle_name": "WILLEM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-935-5630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.