Wade Kifer D.D.S., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3468 Issued in AR

Legal business name

WADE KIFER D.D.S., P.A.

Practice address

1845 N Green Acres Rd
Fayetteville, AR 72703-2615

Phone

(479) 521-2002

Fax

(479) 444-7202

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wade Kifer, D.D.S.

Title

President

Phone

(479) 521-2002

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1982806501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032615",
            "telephone_number": "479-521-2002",
            "fax_number": "479-444-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032615",
            "telephone_number": "479-521-2002",
            "fax_number": "479-444-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE KIFER D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KIFER",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-521-2002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "3468",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELDS",
            "identifier": "5 Y 371",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.