Healthcare Provider Details

I. General information

NPI: 1952772055
Provider Name (Legal Business Name): RICHARD WEIGAND,DDS,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 S SOUTHEAST BLVD SUITE 110
SPOKANE WA
99223-4984
US

IV. Provider business mailing address

2700 S SOUTHEAST BLVD SUITE 110
SPOKANE WA
99223-4984
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-5812
  • Fax: 509-747-3153
Mailing address:
  • Phone: 509-747-5812
  • Fax: 509-747-3153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. RICHARD D WEIGAND
Title or Position: OWNER/OFFICER
Credential: DDS
Phone: 509-747-5812