Ian Wall, is a
Dentist - General Practice based in Sea Cliff, New York. Ian Wall is licensed to practice in New York (license number 064923) and his current practice location is
216 Sea Cliff Ave, Sea Cliff, New York. He can be reached at his office (for appointments etc.) via phone at
(363) 777-9690.
NPI number for Ian Wall is 1659950061 and his current mailing address is 9 Claire Ln, Sayville, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1659950061.
Healthcare Provider's Profile
| Full Name | Ian Wall |
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| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 216 Sea Cliff Ave, Sea Cliff, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1659950061
- Provider Enumeration Date: 04/04/2021
- Last Update Date: 08/06/2025
Medical Identifiers
Medical identifiers for Ian Wall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659950061 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | DN10000220 (Massachusetts) | Secondary |
| 1223G0001X | Dentist - General Practice | 0401417767 (Virginia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | 064923 (New York) | 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. Ian Wall is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ian Wall,
9 Claire Ln,
Sayville, NY 11782-2420
Ph: (631) 766-7279 | Ian Wall,
216 Sea Cliff Ave,
Sea Cliff, NY 11579-1232
Ph: (363) 777-9690 |
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