Adam Joshua Farrell Wandell, DDS, MD

Primary specialty

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

License

105937 Issued in CA

Practice address

445 March Ave Ste B
Healdsburg, CA 95448-3383

Phone

(650) 714-3694

NPI assigned

May 23, 2017

Last updated

Apr 2, 2024By the provider in NPPES

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 15, 2024 through Mar 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lelis Wandell Dental Partnership

  dba Healdsburg Oral Surgery & Dental Implants

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Ukiah, CA
  • NPI 1902650971
  NPD Authorized official
• Wandell Dental Corporation

  dba Healdsburg Oral Surgery & Dental Implants

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Ukiah, CA
  • NPI 1407601164
  NPD Authorized official

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1871021709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9961 HERB RD",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954929435",
            "telephone_number": "650-714-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 MARCH AVE STE B",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483383",
            "telephone_number": "650-714-3694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Gerona Rd",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943058451",
            "country_code": "US",
            "telephone_number": "650-714-3694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANDELL",
        "first_name": "ADAM",
        "middle_name": "JOSHUA FARRELL",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "105937",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "105937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Valencia
• Lilia Valitova, PH.D.
• Julianne Stoll Van Schoor, MD
• Roger Steven Vargas, M.D.
• Tony David Veletto, M.D.
• Wayne Carr Chiropractic, Inc. (Carr Chiropractic, Inc.)
• Wayne S. Carr D.C. Dba Carr Chiropractic
• Katherine Julia Wells, LMFT
• Erica Whisney
• Chelsea Rae Whitaker, DPT

• Oral & Maxillofacial Surgery (D.M.D.) in Healdsburg, CA
• Providers in Healdsburg, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.