Provider Demographics
NPI:1699789701
Name:WALDMAN, DAVID S I (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:WALDMAN
Suffix:I
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 1:2910 BISCAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-2112
Mailing Address - Country:US
Mailing Address - Phone:330-759-9277
Mailing Address - Fax:
Practice Address - Street 1:127 CHURCHILL HUBBARD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1386
Practice Address - Country:US
Practice Address - Phone:330-759-4550
Practice Address - Fax:330-759-4548
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH146121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice