Wayne T. Tadsen DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN008626 Issued in GA

Legal business name

WAYNE T. TADSEN DMD PC

Practice address

102 Gordon St
Lawrenceville, GA 30045-6910

Phone

(770) 995-6215

Fax

(770) 995-6263

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Theodore Tadsen, DMDNPI 1447373121

Title

President, Owner

Phone

(770) 995-6215

Specialties & licenses 1

Addresses

Practitioners 1

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

• Wayne Theodore Tadsen, D.M.D.

  • General Practice Dentistry
  • Lawrenceville, GA
  • NPI 1447373121
  NPD (past) Authorized official

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407979099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 GORDON ST",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456910",
            "telephone_number": "770-995-6215",
            "fax_number": "770-995-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GORDON ST",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456910",
            "telephone_number": "770-995-6215",
            "fax_number": "770-995-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE T. TADSEN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TADSEN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "770-995-6215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN008626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Granada Rebecca Watson
• Kristie Watson
• Robin Watson, M.ED.
• Shernett Watson, RN
• Onathia Georgette Watts, LPN
• Alissa Elaine Wayne, LCSW
• Fatoumata Waziri
• We DO Care, Inc.
• Vida A Weaver, RN
• Patricia Webb, MS

• General Practice Dentistry in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.