DR. DOUGLAS NEIL WADE (NPI# 1649214248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649214248 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS NEIL WADE |
| Credential | DDS |
| Practice Address |
4th & Inner Loop Road Bldg. 171 Fort Irwin CA 92310-5076 |
| Mailing Address |
Bldg. 171, 4th & Inner Loop Road Fort Irwin CA 92310-5076 |
| Practice Telephone | 7603805733 |
| Practice Fax Number | 7603804996 |
| Mailing Telephone | 7603805733 |
| Mailing Fax Number | 7603804996 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
37033 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962069260 | Douglas Wade | Physical Therapy Assistant | 38 Betty Ct, Jacksonville, AL 36265-8814 | 2019-05-22 |
| Street Address |
4TH & INNER LOOP ROAD BLDG. 171, |
| City | FORT IRWIN |
| State | CA |
| Zip Code | 92310-5076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710960620 | Jordan H.q. Tran | Dentist | 4th & Inner Loop Road, Building 171, Fort Irwin, CA 92310 | 2005-11-23 |
| 1922457027 | Michelle L Evans | Dental Assistant | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2016-06-09 |
| 1023467123 | Frances Marie Lee | Dental Assistant | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2016-06-09 |
| 1477902070 | Joshua Allen Hennis | Dental Assistant | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2016-06-06 |
| 1073999777 | Ryan Steven Payne | Dentist | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2015-08-04 |
| 1114243334 | Douglas Norris Waterman | Dentist | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2010-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100568 | Kellyann Michelle Francis | Dental Hygienist | 171, 4th St., Fort Irwin, CA 92310 | 2020-10-06 |
| 1598362253 | Lauren Elisabeth O'keefe | Dental Hygienist | 172 4th Street, Fort Irwin, CA 92310 | 2020-10-06 |
| 1215583737 | Lyra Angelica Velayo Matin | Marriage & Family Therapist | Bldg 390 N Loop Road, Fort Irwin, CA 92310 | 2019-08-12 |
| 1003384629 | Gary Barrow | Chiropractor | 390 Outerloop Rd, Fort Irwin, CA 92310 | 2018-11-13 |
| 1801373055 | Lee John Bizon Jr. | Nurse Practitioner | 390 North Loop Rd, Fort Irwin, CA 92310 | 2018-07-20 |
| 1619489937 | Ronda Marie Shiro | Dental Assistant | 171 Inner Loop Rpad, Fort Irwin, CA 92310 | 2017-10-26 |
| 1841713195 | James Degroot | Registered Nurse | Weed Army Community Hospital 390 North Loop Rd., Fort Irwin, CA 92310 | 2017-07-19 |
| 1356897615 | Alan Josiah Mills II | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2016-08-28 |
| 1568917136 | Kathryn Paine | Physical Therapist | Building 390, North Loop Rd, Fort Irwin, CA 92310 | 2016-08-23 |
| 1487003588 | Kristyn Lauren Ollison | Dental Assistant | Bldg 248 A Meddac, Fort Irwin, CA 92310 | 2016-06-09 |
| Find all providers in zip 92310 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851609713 | Barrett Nash Beardsley | Dentist | 171 Inner Loop Road, Fort Irwin, CA 92310 | 2010-09-14 |
| 1922257021 | Clint Tyler Shelley | Dentist | 4th & Interloop Road, Bldg 171, Box 105076, Fort Irwin, CA 92310 | 2008-09-12 |
| 1346291663 | Dolores Luque | Dentist | Building 171, 4th & Inner Loop Rd, Fort Irwin, CA 92310-5076 | 2006-05-12 |
| 1528017613 | George Joseph Hucal | Dentist | Bldg. 171, 4th & Inner Loop Road, U.S. Army Dental Activity, Fort Irwin, CA 92310-5076 | 2006-05-08 |
| 1841270030 | Louis Rembert Kubala | Dentist | Us Dental Activity, Bldg 171 4th Inner Loop Rd, Fort Irwin, CA 92310-1507 | 2006-01-23 |
| 1023597333 | Stephanie Heejin Chung | Dentist | 170 Inner Loop Road, Fort Irwin, CA 92310 | 2018-08-08 |
| 1376029991 | Paul Chung | Dentist | 170 Inner Loop Road, Fort Irwin, CA 92310 | 2018-07-17 |
| 1073999777 | Ryan Steven Payne | Dentist | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2015-08-04 |
| 1245547520 | Joshua Hyungkyu Lee | Dentist | 4th and Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2010-09-08 |
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| 1104425248 | Aditi Mehndiratta | Dentist | 17585 Vierra Canyon Rd, Prunedale, CA 93907-3312 | 2020-10-20 |
| 1346849452 | Lauren Gabrielle Alfonso Santos | Dentist | 4005 Manzanita Ave Ste 50, Carmichael, CA 95608-1784 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | FORT IRWIN |
| Zip Code | 92310 |
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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.