DR. MITZI M. WADE DDS NPI 1124203013

NPI Information

NPI: 1124203013
Provider Name: DR. MITZI M. WADE, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
2016 MAIN AVE SW
CULLMAN, AL
ZIP 35055
Phone: (256) 775-0230
Get Directions

DR. Mitzi M. Wade, DDS is a general practice dentist in Cullman, AL. The provider is 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. DR. Mitzi M. Wade, DDS NPI is 1124203013. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2016 MAIN AVE SW
CULLMAN, AL
ZIP 35055-239
Phone: (256) 775-0230
Fax: (256) 735-0943

The enumeration date for this NPI number is 1/9/2008 and was last updated on 3/29/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		8793	TENNESSEE	No
2	1223G0001X	Dentist	General Practice	5792	ALABAMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	122611	MEDICAID	ALABAMA
2	122617	MEDICAID	ALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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