Tanya C. Wall, DDS

Pediatric Dentistry · Jacksonville, FL

Individual Active NPI

NPI number 1063528586

Practice location

2255 Dunn Ave
Bldg. 700
Jacksonville, FL 32218
Phone
(904) 751-5126
Fax
(904) 751-5146

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NPI record

NPI
1063528586
Entity type
Individual (Type 1)
Enumeration date
August 21, 2006
Last updated
January 8, 2019
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatric Dentistry Primary 1223P0221X DN15601 FL

Mailing address

PO Box 26948
Jacksonville, FL 32226
Phone
(904) 751-5126
Fax
(904) 751-5146

About Dr. Wall

Tanya C. Wall, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatric Dentistry (code 1223P0221X). The practice location is 2255 Dunn Ave, Bldg. 700, Jacksonville, FL 32218. The NPI number 1063528586 was assigned on August 21, 2006 and the record was last updated on January 8, 2019.

Dr. Wall lists a license in the registry: #DN15601 (FL) for Pediatric Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Tanya C. Wall, DDS?

The NPI number is 1063528586.

What is the phone number of Dr. Wall?

The phone number listed for the practice location is (904) 751-5126.

Where is Dr. Wall located?

2255 Dunn Ave, Bldg. 700, Jacksonville, FL 32218.

What is the taxonomy code for Dr. Wall?

The primary taxonomy code is 1223P0221X – Pediatric Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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