Brent John Waldman, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DN28891 Issued in FL

Practice address

13145 Kings Lake Dr
Gibsonton, FL 33534-3962

Phone

(843) 789-9738

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1295717775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15231 MERLINGLEN PL",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335473900",
            "telephone_number": "843-789-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13145 KINGS LAKE DR",
            "city": "GIBSONTON",
            "state": "FL",
            "postal_code": "335343962",
            "telephone_number": "843-789-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "BRENT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410971",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanda Denise Vann
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• Amy M Wagner, ED.S., BCABA
• Wal-Mart Stores East LP
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• Daphne Louise Weeks, APRN
• Teresa E Williams
• Danielle Winston, APRN
• Womens Care Florida LLP
• Brenda L Worzel, LMT

• Dentist in Gibsonton, FL
• Providers in Gibsonton, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.