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NPI Code Detail

MEDICARE: REBAZ WAISE

MEDICARE: REBAZ WAISE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)0438000487VA
2122300000XDentist18178MD
3122300000XDentist0401416705VA

General Provider Information

NPI Number : 1093277808
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBAZ WAISE
Provider Business Mailing Address
First Line : 7934 WENTWORTH PL
Second Line :
City : SPRINGFIELD
State : VA
Zip : 22152-3440
Country : US
Telephone Number : 703-965-1514
Fax Number :
Provider Business Practice Location Address
First Line : 1286 E WEST HWY
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-3242
Country : US
Telephone Number : 301-761-4489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2019
Last Update Date : 01/08/2026

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Directions to “ REBAZ WAISE ” Practice Location

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