What is Kraig Vandewalle's NPI number?

The NPI number assigned to this healthcare provider is 1396710182, enumerated as a individual on February 23, 2006.

What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

DR. KRAIG STEPHEN VANDEWALLE DDS, MS - NPI 1396710182

Q: Where is the provider located?

The provider is located at 1100 WILFORD HALL LOOP BLDG 4554 JBSA LACKLAND, TX 78236 and the phone number is (210) 292-0760.

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About Dr. Kraig Stephen Vandewalle Dds, Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KRAIG STEPHEN VANDEWALLE DDS, MS (NPI 1396710182) is an individual general practice provider in Jbsa Lackland, Texas, licensed in Texas (14137) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1396710182

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KRAIG STEPHEN VANDEWALLECredential: DDS, MS

Location Address1100 WILFORD HALL LOOP BLDG 4554Jbsa Lackland, TX 78236-5638

Mailing Address1615 Truemper StJbsa Lackland, TX 78236-5511

Phone(210) 292-0760

Sole ProprietorNo

Enumeration DateFebruary 23, 2006

Last NPPES UpdateJanuary 27, 20212 updates tracked since enumeration

NPPES CertifiedJanuary 27, 2021

✔ NPI 1396710182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in TX · 14137

Definition

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.

1100 WILFORD HALL LOOP BLDG 4554, Jbsa Lackland, TX 78236

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