Tonie Waller, DDS in Ada, OK - Medicare Dentist Provider

Tonie Waller, DDS is a medicare enrolled "Dentist" provider in Ada, Oklahoma. His current practice location is 1921 Stonecipher Boulevard, Ada, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (580) 436-3980.

Tonie Waller is licensed to practice in Oklahoma (license number 5058) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720284458.

Contact Information

	Tonie Waller, DDS
	1921 Stonecipher Boulevard, Ada, OK 74820-3439
	(580) 436-3980
	(580) 421-6283

Healthcare Provider's Profile

Full Name	Tonie Waller
Gender	Male
Speciality	Dentist
Location	1921 Stonecipher Boulevard, Ada, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720284458
Provider Enumeration Date: 06/21/2007
Last Update Date: 05/18/2015

Medicare PECOS Information:

PECOS PAC ID: 3971824111
Enrollment ID: I20150601000407

Medical Identifiers

Medical identifiers for Tonie Waller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720284458	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	5058 (Oklahoma)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tonie Waller is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Tonie Waller, DDS 1921 Stonecipher Boulevard, Ada, OK 74820-3439 Ph: (580) 436-3980	Tonie Waller, DDS 1921 Stonecipher Boulevard, Ada, OK 74820-3439 Ph: (580) 436-3980

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Dentist in Ada, OK

Dr. Joshua Allen Mayo, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-436-3980 Fax: 580-421-6283
Dr. Morgan Lee Moody, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1430 Lonnie Abbott Blvd, Ada, OK 74820 Phone: 580-279-1716
Dr. Marty Ray Scantlen, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-436-3980
Vashti Osborn, Dentist Medicare: Not Enrolled in Medicare Practice Location: 1430 Lonnie Abbott Blvd, Ada, OK 74820 Phone: 580-279-1716 Fax: 580-279-1591
Brandon Scott Rogers, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 1921 Stonecipher Blvd, Ada, OK 74820 Phone: 580-436-3980 Fax: 580-421-6283
Dr. Benjamin Franklin Edwards Jr., DDS Dentist Medicare: Medicare Enrolled Practice Location: 1801 East Arlington, Ada, OK 74820 Phone: 580-332-1660 Fax: 580-421-9009
Dr. Terry Glen Haney, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-421-4596 Fax: 580-421-4595

Tonie Waller, DDS - Medicare Dentist in Ada, OK