Wayne Gergens, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60771319 Issued in WA

Practice address

19720 68TH Ave W
Lynnwood, WA 98036-4568

Phone

(806) 679-1788

NPI assigned

Aug 31, 2016

Last updated

Mar 8, 2022By the provider in NPPES

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": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1659827517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W 6TH AVE STE 161",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263106",
            "telephone_number": "806-679-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19720 68TH AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364568",
            "telephone_number": "806-679-1788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 East Campus Loop South",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685830740",
            "country_code": "US",
            "telephone_number": "402-472-3249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERGENS",
        "first_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7329",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60771319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gentle Guardian Adult Family Care LLC
• Cynthia G. George, PT
• Karyn E George, M.A.
• Brenna Sue Georgis
• Ingrid F Gerbino, MD
• Nathan Ghebrehiwot
• Tina Giang
• Tyler Mathew Gibbs
• Shelita Gibson
• Jamie Giganti

• Dentist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.