Provider Demographics
NPI:1316057151
Name:WAYMIRE, MELVIN SYLVESTER JR (DDS)
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:SYLVESTER
Last Name:WAYMIRE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7480 BRANDT PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3240
Mailing Address - Country:US
Mailing Address - Phone:937-237-7170
Mailing Address - Fax:937-237-7148
Practice Address - Street 1:7480 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:HYBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3240
Practice Address - Country:US
Practice Address - Phone:937-237-7170
Practice Address - Fax:937-237-7135
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300167161223G0001X, 1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
No1223G0001XDental ProvidersDentistGeneral Practice