Brian Wardell, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019025869 Issued in IL

Practice address

522 Chestnut St
Suite Ga
Hinsdale, IL 60521-3171

Phone

(630) 655-3636

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217030400000",
    "number": "1790763860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 CHESTNUT ST",
            "address_2": "SUITE GA",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213171",
            "telephone_number": "630-655-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 CHESTNUT ST",
            "address_2": "SUITE GA",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213171",
            "telephone_number": "630-655-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDELL",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2008-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025869",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021002266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #01670)
• Nicole Walsh
• Thomas Walsh, DO
• John Wander, M.D.
• Dan Wang
• Jesse G. Wardlow, M.D.
• Daniel Watts, CRNA
• Audrey L Wayne, MD
• Wclegal Associates, LLC
• Karen Mary Weatherford-Zaluzec, NP

• Dentist in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.