Emile Joseph Waked II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

BW50113 Issued in CA

Practice address

1108 E Clark Ave Ste 160
Santa Maria, CA 93455-5189

Phone

(805) 937-2059

Fax

(805) 937-0762

NPI assigned

Jan 18, 2007

Last updated

Apr 13, 2009By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Waked Dental Corporation Inc

  • General Practice Dentistry
  • Orcutt, CA
  • NPI 1154273654
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1841342904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 E CLARK AVE STE 160",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555189",
            "telephone_number": "805-937-2059",
            "fax_number": "805-937-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E CLARK AVE STE 160",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555189",
            "telephone_number": "805-937-2059",
            "fax_number": "805-937-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKED",
        "first_name": "EMILE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "BW50113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alycia Vreeland
• VTC Enterprises
• VTC Enterprises
• Della Wagner
• Ronnie Wagner
• Jennifer Claire Waldron
• Michael S Waldron
• Walgreen Co (Walgreens #06287)
• Walgreen Co (Walgreens #06288)
• Walgreens Pharmacy

• General Practice Dentistry in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.