DR. MATTHEW D WALL (NPI# 1114253846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114253846 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW D WALL |
| Credential | DDS, MSD |
| Practice Address |
5320 Corporate Center Loop Se Lacey WA 98503-5557 |
| Practice Telephone | 3604917080 |
| Mailing Telephone | 3604917080 |
| Enumeration Date | 2009-10-31 |
| Last Update Date | 2009-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DE60048046 | WA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718461 | Matthew Wall | Student in an Organized Health Care Education/Training Program | 5323 Harry Hines Blvd, Dallas, TX 75390-7709 | 2020-04-04 |
| 1083247209 | Matthew Tyler Wall | Student in an Organized Health Care Education/Training Program | 1919 7th Ave S, Birmingham, AL 35233-2005 | 2020-02-17 |
| 1902461742 | Matthew Wall | Case Manager/Care Coordinator | 10 West St, Concord, NH 03301-3548 | 2019-05-07 |
| 1629214820 | Matthew Ryan Wall | Dentist | 625 W Southern Ave Ste E-145, Mesa, AZ 85210-5030 | 2008-12-18 |
| 1952500662 | Matthew Wall | Internal Medicine | 118 Northport Ave, Belfast, ME 04915-6009 | 2007-07-12 |
| 1114016581 | Matthew Wall | Surgery | 1504 Taub Loop, Houston, TX 77030-1608 | 2006-10-12 |
| Street Address |
5320 CORPORATE CENTER LOOP SE |
| City | LACEY |
| State | WA |
| Zip Code | 98503-5557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043332844 | Kevin Carroll Moss | Dentist | 5320 Corporate Center Loop Se, Suite A, Lacey, WA 98503 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457838989 | Michele Nordgren Bourque | Psychologist | 4329 Concordia Lane Se, Lacey, WA 98503 | 2018-07-26 |
| 1831638675 | Trevor John Marum | Chiropractor | 3945 8th Ave Se, Lacey, WA 98503 | 2017-02-13 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1144683616 | Millenda Thomas | Registered Nurse | 1233 Firpark Dr. S.e., Lacey, WA 98503 | 2016-04-01 |
| 1609257245 | Erika Charlotte Vonkotzebue | Counselor | 4401 37th Ave. Se #25, Lacey, WA 98503 | 2015-06-09 |
| 1437576196 | Candy Nelson | Registered Nurse | 4410 6th Ave Se, Apt# 115, Lacy, WA 98503 | 2014-03-19 |
| 1134563919 | Alvin Fitzgerald | Pharmacist | 665 Sleater Kinney Rd., S.e, Target Pharmacy #1355, Lacey, WA 98503 | 2013-04-23 |
| 1518200724 | Katherine Mary Marsh | Psychologist | 5191 Corporate Center Court Se, Lacey, WA 98503 | 2013-04-05 |
| 1740530906 | Leanna Marie Mcbroom | Massage Therapist | 1608 Diamond Loop Se, Lacey, WA 98503 | 2012-09-14 |
| 1831445196 | Joyce Emily Christensen Coniff | Counselor | 5706 39th Ave Se., Lacey, WA 98503 | 2012-07-24 |
| Find all providers in zip 98503 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962888636 | Matthew D Wall Dds Msd Pllc | Dentist | 5320 Corporate Center Loop Se Ste A, Lacey, WA 98503-5557 | 2015-08-05 |
| 1619359080 | June Q Lei | Dentist | 5122 Yelm Hwy Se, Suite E, Lacey, WA 98503-5034 | 2015-06-22 |
| 1578610788 | Zachary P Ehrmantrout | Dentist | 130 Marvin Rd Se, Suite 111, Lacey, WA 98503-6100 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539301 | Jack Hou & Kortne Frederick Hou PC | Dentist | 22603 Ne Inglewood Hill Rd Ste 200, Sammamish, WA 98074-7105 | 2020-08-19 |
| 1629686175 | Paul S. Kahlon, Pllc | Dentist | 13209 44th Ave Se Ste 102, Mill Creek, WA 98012-8985 | 2020-07-21 |
| 1457975948 | Hurst and Shannon Pllc | Dentist | 400 Pine St Ste 2017, Seattle, WA 98101-3625 | 2020-06-01 |
| 1043840200 | Kjeld Aamodt PC | Dentist | 500 108th Ave Ne Ste 1710, Bellevue, WA 98004-5598 | 2020-01-16 |
| 1861040800 | Jack Hou & Kortne Frederick Hou PC | Dentist | 451 Duvall Ave Ne Ste 230, Renton, WA 98059-4675 | 2019-09-03 |
| 1972165942 | Claire Kuo Pllc | Dentist | 4300 Talbot Rd S Ste 401, Renton, WA 98055-6238 | 2019-06-30 |
| 1164089934 | Tri-city Orthodontics, LLC | Dentist | 3200 Duportail St, Ste 203, Richland, WA 99352 | 2019-05-28 |
| 1699331363 | Chet Jenkins PC | Dentist | Pioneer Specialty Services, 110 W Yakima Valley Hwy, Sunnyside, WA 98944-1352 | 2019-05-17 |
| 1578025946 | Samuel Finkleman | Dentist | 411 Strander Blvd Ste 104, Tukwila, WA 98188-2924 | 2019-04-03 |
| 1891250429 | Daniel Lee, Dds, and Christina Lee, Dds, Ms, Pllc | Dentist | 2911 2nd Ave, Suite 106, Seattle, WA 98121-3065 | 2019-02-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.