John Phillip Waschak, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D9097 Issued in OR

Practice address

560 NE E St
Grants Pass, OR 97526-2326

Phone

(541) 476-8383

Fax

(541) 470-0751

NPI assigned

Jul 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1265632715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 NE E ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262326",
            "telephone_number": "541-476-8383",
            "fax_number": "541-470-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 NE E ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262326",
            "telephone_number": "541-476-8383",
            "fax_number": "541-470-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASCHAK",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OR",
            "license": "D9097",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "55033",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "55033",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D9097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Shaevon Warner
• Allegra Nicole Warren
• Beth Warren, LMT
• Sierra Dawn Warren
• Alexis Nicole Warrick
• Trevor Washburn, MD
• Catherine J Watson
• Michael John Watson, CADC 1
• Angela Watton
• Lucy Laurel Way, MS; LPC

• Pediatric Dentistry in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.