Healthcare Provider Details

I. General information

NPI: 1205901071
Provider Name (Legal Business Name): WAYNE L FAULKNER DDS PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8592 POTTER PARK DR STE 150
SARASOTA FL
34238-5468
US

IV. Provider business mailing address

8592 POTTER PARK DR STE 150
SARASOTA FL
34238-5468
US

V. Phone/Fax

Practice location:
  • Phone: 941-298-0198
  • Fax:
Mailing address:
  • Phone: 941-298-0198
  • Fax: 941-298-0198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberBF7452648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: