Provider Demographics
NPI:1053416685
Name:REMINGTON, WAYNE DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:DAVID
Last Name:REMINGTON
Suffix:
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 1:1522B INSURANCE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7229
Mailing Address - Country:US
Mailing Address - Phone:434-973-7744
Mailing Address - Fax:434-975-0250
Practice Address - Street 1:1522B INSURANCE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7229
Practice Address - Country:US
Practice Address - Phone:434-973-7744
Practice Address - Fax:434-975-0250
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401-006110122300000X
VA0401006110122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA54-1829449OtherTAXPAYER ID #