Individual provider Active NPI

Marcia Carol Wadell, D.D.S, M.S.

  • Periodontics
  • San Francisco, CA
National Provider Identifier
1780050898
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D22930 Issued in CA
Practice address
707 Parnassus Ave
UCSF Box 0762
San Francisco, CA 94143-0762
Phone
(650) 619-0803
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X D22930 CA Primary

Addresses

Primary practice location

707 Parnassus Ave
UCSF Box 0762
San Francisco, CA 94143-0762

Mailing address

707 Parnassus Ave
UCSF Box 0762
San Francisco, CA 94143-0762
Phone (650) 619-0803

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D22930CAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1780050898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 PARNASSUS AVE",
            "address_2": "UCSF BOX 0762",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430762",
            "telephone_number": "650-619-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PARNASSUS AVE",
            "address_2": "UCSF BOX 0762",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430762",
            "telephone_number": "650-619-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADELL",
        "first_name": "MARCIA",
        "middle_name": "CAROL",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "D22930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.