Wayne William Maibaum, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38654 Issued in NY

Practice address

939 Route 376
Suite 1
Wappingers Falls, NY 12590

Phone

(845) 223-9987

NPI assigned

Jun 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386848414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PLEASANT RIDGE RD EXT",
            "city": "POUGHQUAG",
            "state": "NY",
            "postal_code": "125704952",
            "telephone_number": "845-724-4352",
            "fax_number": "845-724-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 ROUTE 376",
            "address_2": "SUITE 1",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "12590",
            "telephone_number": "845-223-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIBAUM",
        "first_name": "WAYNE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "38654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Marie Lussier, MS, OTR/L
• Renee Macdonald, LCSW
• Shannon Marie Madden, OTR/L
• Deirdra Maguire
• Haatsari R Mahlunge Mumanyi, OTR/L
• Michelle Alison Majors, MSPT
• Patrick James Malonzo, PHARMD
• Michael Edward Manasar, DDS
• Marlaina Marie Mancini
• Deepak Raj Manoharan, DDS

• General Practice Dentistry in Wappingers Falls, NY
• Providers in Wappingers Falls, NY by specialty
• General Practice Dentistry in New York

• 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.