DR. SAMUEL MOORE WALLDEN (NPI# 1811348287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811348287 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL MOORE WALLDEN |
| Credential | D.M.D. |
| Practice Address |
6075 Vantage Pl Rockford IL 61107-5905 |
| Practice Telephone | 8153990677 |
| Mailing Telephone | 8153990677 |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2016-06-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.030757 | IL | Dental Providers |
| Street Address |
6075 VANTAGE PL |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891897799 | Kelly J. Moore D.d.s., P.C. | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2006-09-01 |
| 1558814897 | Thomas H. Moore D.d.s. Ltd | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2016-08-03 |
| 1487788709 | Lindsay Danielle Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-16 |
| 1588798813 | Ryan Thomas Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-16 |
| 1366575722 | Tom Harold Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-14 |
| 1639202914 | Thomas H. Moore Dds Ltd | Clinic/Center | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-14 |
| 1396847216 | Kelly James Moore | Dentist | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| 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 |
|---|---|---|---|---|
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1295192144 | Woolery Dental P.C. | Dentist | 5301 E State St Ste 306, Rockford, IL 61108-2390 | 2016-01-23 |
| 1467849679 | Christopher Lee Greenwaldt | Dentist | 845 S Perryville Rd Unit 127, Rockford, IL 61108-4340 | 2015-04-26 |
| 1427463785 | Yong Woo Lee | Dentist | 7310 Walton St, Rockford, IL 61108-4614 | 2014-06-25 |
| 1750624110 | Austriaco Dental Associates LLC | Dentist | 7310 Walton St Ste A, Rockford, IL 61108-4614 | 2013-04-03 |
| 1609173749 | Kathryn Ashley Edgcomb | Dentist | 1376 Reid Farm Rd, Rockford, IL 61107-2679 | 2011-02-25 |
| 1629393962 | Affordable Dentistry Today | Dentist | 5819 E Riverside Blvd # 21, Rockford, IL 61114-4963 | 2010-03-30 |
| 1346563525 | Modern Dental of Rockford LLC | Dentist | 1321 Sandy Hollow Rd, Rockford, IL 61109-2120 | 2010-03-02 |
| 1063667079 | Wilson Dental, PC | Dentist | 610 E. Division, Rockford, MI 49341 | 2008-11-19 |
| Find all providers in ROCKFORD | ||||
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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.