# DR. WADE ARTHUR MENDENHALL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275543233
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5259 | AZ | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 538340 | APIPA | AZ |
| 01 | — | 53840 | CDMP | — |
| 01 | — | 666280 | UNITED CONCORDIA | AZ |
| 01 | — | AZ0498470 | BCBS OF AZ | AZ |