Healthcare Provider Details

I. General information

NPI: 1255334827
Provider Name (Legal Business Name): REBECCA WEINMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 PEACHTREE RD NE STE 1685
ATLANTA GA
30326-1012
US

IV. Provider business mailing address

3340 PEACHTREE RD NE STE 1685
ATLANTA GA
30326-1012
US

V. Phone/Fax

Practice location:
  • Phone: 404-266-1300
  • Fax: 404-365-8526
Mailing address:
  • Phone: 404-266-1300
  • Fax: 404-365-8526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberGA 10187
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: