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General NPI Number Information
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NPI Number | 1649679085
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Entity Type | Individual
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Provider Name | WAYNE STEPHENS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 5607 NW 27TH AVE SUITE 2
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City | MIAMI
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State | FL
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Zip | 33142-2826
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Country | US
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Telephone | 305-636-3336
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Fax |
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Provider Business Mailing Address
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Address Line | 808 S 5TH AVE
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City | DENTON
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State | MD
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Zip | 21629-1398
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Country | US
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Telephone | 410-479-2650
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Fax | 833-916-1012
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0562251
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN20205
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 18018
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License Number State | MD
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