Healthcare Provider Details

I. General information

NPI: 1245158286
Provider Name (Legal Business Name): WAYPOINT PERIODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 TRAP FALLS RD STE 202
SHELTON CT
06484-7626
US

IV. Provider business mailing address

2 TRAP FALLS RD STE 202
SHELTON CT
06484-7626
US

V. Phone/Fax

Practice location:
  • Phone: 203-446-3890
  • Fax: 203-446-3889
Mailing address:
  • Phone: 203-446-3890
  • Fax: 203-446-3889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: LAVANYA RAJENDRAN
Title or Position: OWNER
Credential: DMD
Phone: 203-379-7006