Active NPI
Charles William Wakefield, DDS
- General Practice Dentistry
- Lewisville, TX
National Provider Identifier
1982860854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18399
- Practice address
- 326 S Edmonds LN
Lewisville, TX 75067-3580 - Phone
- (972) 221-9334
- Fax
- (972) 436-7130
- NPI assigned
- Jul 31, 2008
- Last updated
- Jul 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18399 | TX | Primary |
Addresses
Primary practice location
326 S Edmonds LN
Lewisville, TX 75067-3580
Mailing address
326 S Edmonds LN
Lewisville, TX 75067-3580
Phone (972) 221-9334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18399 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1982860854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 S EDMONDS LN",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673580",
"telephone_number": "972-221-9334",
"fax_number": "972-436-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 S EDMONDS LN",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673580",
"telephone_number": "972-221-9334",
"fax_number": "972-436-7130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKEFIELD",
"first_name": "CHARLES",
"middle_name": "WILLIAM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "18399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
- W. Main Street Dental Lewisville, TX, P.C. (Jubilee Dental)
- Brittany Waddell, LMSW
- Emily Waddell, BCBA
- Josephine Fenwi Waindim, MD
- Brian E. Wakefield, DDS
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3287)
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-5092)
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 100217)
- Wal-Mart Stores Texas LP (Wal-Mart Vision Center 30-5092)
- Wal-Mart Stores Texas, LP (Vision Center 30-0426)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.