Active NPI
Wayne Joseph Dollard, D.D.S.
- Endodontics
- Reston, VA
National Provider Identifier
1972697043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0401006443
- Practice address
- 11503 Sunrise Valley Dr
Reston, VA 20191-1505 - Phone
- (703) 680-3200
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 0401006443 | VA | Primary |
Addresses
Primary practice location
11503 Sunrise Valley Dr
Reston, VA 20191-1505
Mailing address
529 Pelican Way
Delray Beach, FL 33483
Phone (561) 279-2578
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401006443 | VA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1972697043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "529 PELICAN WAY",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "33483",
"telephone_number": "561-279-2578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11503 SUNRISE VALLEY DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201911505",
"telephone_number": "703-680-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLLARD",
"first_name": "WAYNE",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "VA",
"license": "0401006443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.