Michael Vincent Wall, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

8394 Issued in AZ

Practice address

3552 W Glendale Ave
Ste. B
Phoenix, AZ 85051-8358

Phone

(602) 888-7844

NPI assigned

Jan 14, 2009

Last updated

Sep 22, 2016By 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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1932346897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8151 E INDIAN BEND RD",
            "address_2": "STE 111",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852504826",
            "telephone_number": "407-680-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3552 W GLENDALE AVE",
            "address_2": "STE. B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850518358",
            "telephone_number": "602-888-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MICHAEL",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-14",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57415",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan T Wall, MD
• Clarence R Wall, M.D.
• Heather Wall, LCSW
• Jillian Marie Wall, M.D.
• Liberty Morgan Wall
• Richard A Wall, M.D.
• Sophia Wall, DMD
• Sterling Wall, DDS
• Tracy Wall
• Victoria M Wall

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.