Individual provider Active NPI

Wayland A Easley, DDS

  • Dentist
  • Warwick, RI
National Provider Identifier
1770780645
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN02883 Issued in RI
Practice address
230 Airport Rd
Warwick, RI 02889
Phone
(401) 732-4117
Fax
(401) 352-0807
NPI assigned
Jul 2, 2007
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21302 MA
Dentist 122300000X 051644 NY
Dentist 122300000X DEN02883 RI Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0223000 MASSHEALTH MA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0223000 DORAL DENTAL MA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X AGHDREXEL OMS PA
Anesthesiology Physician 207L00000X 2130220 MA
Anesthesiology Physician 207L00000X DAPA02663 RI

Addresses

Primary practice location

230 Airport Rd
Warwick, RI 02889

Mailing address

230 Airport Rd
Warwick, RI 02889
Phone (401) 732-4117

Other identifiers 3

IdentifierTypeStateIssuer
WE57613MedicaidRI
0223000OtherMADORAL : BMC HEALTH PLAN,NEIGHBORHOOD(MA),NETWORK HEALTH, SR. WHOLE HEALTH
0223000MedicaidMA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
21302MAMDDentist
DEN02883RIMDDentist
0223000 DORAL DENTALMAMDOral and Maxillofacial Surgery (Dentist)
0223000 MASSHEALTHMAMDOral and Maxillofacial Surgery (Dentist)
AGHDREXEL OMSPAMDOral and Maxillofacial Surgery (Dentist)
2130220MAMDAnesthesiology Physician
DAPA02663RIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joel H. Harrison, DMD, LTD Oral and Maxillofacial Surgery CurrentSince Oct 6, 2024 Accepting new patients
Joel H Harrison DMD LTD Oral and Maxillofacial Surgery PastSince Oct 6, 2024 Accepting new patients

Locations

230 Airport Rd
Warwick, RI 02889
Phone (401) 732-4117

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1770780645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 AIRPORT RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02889",
            "telephone_number": "401-732-4117",
            "fax_number": "401-352-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 AIRPORT RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02889",
            "telephone_number": "401-732-4117",
            "fax_number": "401-352-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASLEY",
        "first_name": "WAYLAND",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21302",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051644",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN02883",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "0223000 MASSHEALTH",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "0223000 DORAL DENTAL",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "AGHDREXEL OMS",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "2130220",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "RI",
            "license": "DAPA02663",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WE57613",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL : BMC HEALTH PLAN,NEIGHBORHOOD(MA),NETWORK HEALTH, SR. WHOLE HEALTH",
            "identifier": "0223000",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0223000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.