Wade Family Dental

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

W3829 Issued in WI

Legal business name

WADE FAMILY DENTAL

Practice address

1547 E Racine Ave
Waukesha, WI 53186-6826

Phone

(262) 542-4466

Fax

(262) 542-6105

NPI assigned

Feb 18, 2016

Last updated

Feb 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Donald John Wade, DDSNPI 1093866238

Title

Owner

Phone

(262) 542-4466

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donald Wade, D.D.S.

  • Dentist
  • Waukesha, WI
  • NPI 1093866238
  NPD (past) Authorized official

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1871952820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 E RACINE AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531866826",
            "telephone_number": "262-542-4466",
            "fax_number": "262-542-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 E RACINE AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531866826",
            "telephone_number": "262-542-4466",
            "fax_number": "262-542-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-542-4466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WI",
            "license": "W3829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33684200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Voss, DPT
• VT-Telemedicine LLC
• Casey William Vullings
• Megan Vylonis, D.O.
• Desiree Wachtendonk
• Donald Wade, D.D.S.
• Thomas John Wade, M.D.
• Amber L Wagner, PA-C
• Kayla Rose Wagner, PA-C
• Geneva M Wahl, M.D.

• Point of Service in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Point of Service in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.