Mark Wade Wingate, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

16407 Issued in TX

Practice address

5001 Lakewood Drive
Waco, TX 76710-2920

Phone

(254) 772-0180

Fax

(254) 772-0181

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992854376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LAKEWOOD DRIVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102920",
            "telephone_number": "254-772-0180",
            "fax_number": "254-772-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 LAKEWOOD DRIVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102920",
            "telephone_number": "254-772-0180",
            "fax_number": "254-772-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGATE",
        "first_name": "MARK",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "16407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "BCBSD16407",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Wilson, SLP
• Tiffany A Wilson, LVN
• Tom W. Wilson, PHARMD.
• William Bennett Wilson, M.D.
• Wendy Michele Winarick, D.D.S.
• Charlene Winston
• Aaron Wise, MD
• Faith Nicole Witt, BT
• Robert Cameron Witt, D.D.S.
• Shaniece Denise Witte, PT, DPT

• Dentist in Waco, TX
• Providers in Waco, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.