Provider Demographics
NPI:1093718660
Name:WEINMAN, RICHARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:WEINMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 PEACHTREE RD NE
Mailing Address - Street 2:STE 1685
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1012
Mailing Address - Country:US
Mailing Address - Phone:404-266-1300
Mailing Address - Fax:404-365-8526
Practice Address - Street 1:3340 PEACHTREE RD NE
Practice Address - Street 2:STE 1685
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1012
Practice Address - Country:US
Practice Address - Phone:404-266-1300
Practice Address - Fax:404-365-8526
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 86281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice