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General NPI Number Information
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NPI Number | 1770780645
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Entity Type | Individual
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Provider Name | WAYLAND A EASLEY DDS
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Gender | Male
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 230 AIRPORT RD
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City | WARWICK
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State | RI
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Zip | 02889
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Country | US
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Telephone | 401-732-4117
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Fax | 401-352-0807
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Provider Business Mailing Address
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Address Line | 230 AIRPORT RD
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City | WARWICK
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State | RI
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Zip | 02889
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Country | US
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Telephone | 401-732-4117
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Fax | 401-352-0807
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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 | 21302
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 051644
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0223000 MASSHEALTH
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0223000 DORAL DENTAL
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | AGHDREXEL OMS
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2130220
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License Number State | MA
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Taxonomy #7
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | DAPA02663
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License Number State | RI
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Taxonomy #8
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN02883
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License Number State | RI
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