Organization Active NPI

Gary J Wayne DMD PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Boca Raton, FL
National Provider Identifier
1821291873
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
13403 Issued in FL
Legal business name
GARY J WAYNE DMD PA
Practice address
2500 N Military TRL
Suite 308
Boca Raton, FL 33431-6344
Phone
(561) 443-7001
Fax
(561) 443-7087
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Dr. Gary Jon Wayne, DMDNPI 1023060498
Title
Owner
Phone
(561) 443-7001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 13403 FL Primary

Addresses

Primary practice location

2500 N Military TRL
Suite 308
Boca Raton, FL 33431-6344

Mailing address

2500 N Military TRL
Suite 308
Boca Raton, FL 33431-6344
Phone (561) 443-7001

National Provider Directory

National Provider Directory

Locations

7301A W Palmetto Park Rd
Ste 306B
Boca Raton, FL 33433
Phone (321) 347-2992

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1821291873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N MILITARY TRL",
            "address_2": "SUITE 308",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316344",
            "telephone_number": "561-443-7001",
            "fax_number": "561-443-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N MILITARY TRL",
            "address_2": "SUITE 308",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316344",
            "telephone_number": "561-443-7001",
            "fax_number": "561-443-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY J WAYNE DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "WAYNE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-443-7001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "13403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; 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.