DR. NICHOLAS PATRICK WALL DDS NPI 1225169154

NPI Information

  • NPI: 1225169154
  • Provider Name: DR. NICHOLAS PATRICK WALL, DDS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3655 W ANTHEM WAY
    SUITE A-117
    ANTHEM, AZ
    ZIP 85086
  • Phone: (623) 551-5555

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NPI Details

DR. Nicholas Patrick Wall, DDS is a general practice dentist in Anthem, AZ. 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. Nicholas Patrick Wall, DDS NPI is 1225169154. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3655 W ANTHEM WAY
SUITE A-117
ANTHEM, AZ
ZIP 85086
Phone: (623) 551-5555
Fax: (623) 551-1620

The NPI 1225169154 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/9/2007 and was last updated on 8/19/2008.

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
11223G0001XDentistGeneral PracticeD12321MINNESOTAYes

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: 3/30/2025

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