Individual provider Active NPI

John David Wainio, DDS

  • General Practice Dentistry
  • Duluth, MN
National Provider Identifier
1295846996
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7366 Issued in MN
Practice address
2730 Piedmont Ave
Duluth, MN 55811-6710
Phone
(218) 722-1846
Fax
(218) 722-3552
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7366 MN Primary

Addresses

Primary practice location

2730 Piedmont Ave
Duluth, MN 55811-6710

Mailing address

5180 3Rd Ave
Duluth, MN 55803-9483
Phone (218) 721-3820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D7366MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295846996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 3RD AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558039483",
            "telephone_number": "218-721-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PIEDMONT AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558116710",
            "telephone_number": "218-722-1846",
            "fax_number": "218-722-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAINIO",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D7366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.