NPIMap

Organization Active NPI

Ryan S. Wallin, DDS, PC

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1922210632
Registry record updated Mar 20, 2008
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5282 Issued in AZ
Legal business name
RYAN S. WALLIN, DDS, PC
Practice address
6626 E Baseline Rd
Suite 101
Mesa, AZ 85206
Phone
(480) 218-8800
Fax
(480) 218-7828
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Ronda L Accola
Title
Business Manager
Phone
(480) 218-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5282 AZ Primary

Addresses

Primary practice location

6626 E Baseline Rd
Suite 101
Mesa, AZ 85206

Mailing address

6626 E Baseline Rd
Suite 101
Mesa, AZ 85206
Phone (480) 218-8800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1922210632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E BASELINE RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-218-8800",
            "fax_number": "480-218-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6626 E BASELINE RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-218-8800",
            "fax_number": "480-218-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN S. WALLIN, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "ACCOLA",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "480-218-8800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.