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General NPI Number Information
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NPI Number | 1689513566
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Entity Type | Individual
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Provider Name | JAMES MARTIN WAITE DMD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 103 N FORT THOMAS AVE
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City | FORT THOMAS
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State | KY
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Zip | 41075-1518
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Country | US
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Telephone | 859-360-2118
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Fax |
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Provider Business Mailing Address
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Address Line | 103 N FORT THOMAS AVE
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City | FORT THOMAS
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State | KY
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Zip | 41075-1518
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Country | US
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Telephone | 859-360-2118
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 5982
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License Number State | KY
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