TONIE WALLER DDS
NPI 1720284458
Dentist in Ada, OK

Q: What is Tonie Waller's NPI number?

The NPI number for Tonie Waller is 1720284458. It was assigned to this individual provider in the NPPES registry on June 21, 2007.

Q: What is Tonie Waller's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Tonie Waller was last updated on May 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 21, 2007PECOS Enrolled

1921 STONECIPHER BOULEVARD, ADA, OK 74820(580) 436-3980(580) 421-6283 Get Directions Write a Review

NPPES record last updated: May 18, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tonie Waller Dds NPPES

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

TONIE WALLER DDS (NPI 1720284458) is an individual dentist in Ada, Oklahoma, licensed in Oklahoma (5058) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720284458

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameTONIE WALLERCredential: DDS

Location Address1921 STONECIPHER BOULEVARDAda, OK 74820-3439

Mailing Address1921 Stonecipher BoulevardAda, OK 74820-3439 · (580) 436-3980 · Fax (580) 421-6283

Phone(580) 436-3980

Fax(580) 421-6283

Sole ProprietorNo

Enumeration DateJune 21, 2007

Last NPPES UpdateMay 18, 2015

✔ NPI 1720284458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in OK · 5058

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1921 STONECIPHER BOULEVARD, Ada, OK 74820

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tonie Waller Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74820 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAT VAVRICKA CNM

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