Wayne Dunetz DPM Pac LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

9904 Issued in NV

Legal business name

WAYNE DUNETZ DPM PAC LLC

Practice address

4450 E Washington Ave
Las Vegas, NV 89110-5783

Phone

(702) 821-6763

Fax

(702) 684-6015

NPI assigned

Nov 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wayne Adam Dunetz, D.P.MNPI 1245371392

Title

Owner

Phone

(702) 821-6763

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wayne Adam Dunetz, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NV
  • NPI 1245371392
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1104070465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31327",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891731327",
            "telephone_number": "702-821-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 E WASHINGTON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891105783",
            "telephone_number": "702-821-6763",
            "fax_number": "702-684-6015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 S Rainbow Blvd Ste 18",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891460033",
            "country_code": "US",
            "telephone_number": "702-821-6763",
            "fax_number": "702-684-6015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAYNE DUNETZ DPM PAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "DUNETZ",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-821-6763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "9904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wayne W. Wagner, D.D.S., CHTD.
• Jacoby Wayne-Thompson, PHARMD
• Lisa Wayne
• Waynefargo Icare LLC
• Waypoint Mental Health, LLC

• Podiatrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Podiatrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.