Provider Demographics
NPI:1477663904
Name:WEINER, SEYMOUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEYMOUR
Middle Name:
Last Name:WEINER
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 1:8200 W SUNRISE BLVD STE B2
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5112
Mailing Address - Country:US
Mailing Address - Phone:954-404-4633
Mailing Address - Fax:954-166-5773
Practice Address - Street 1:8200 W SUNRISE BLVD
Practice Address - Street 2:SUITE B-2
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-5112
Practice Address - Country:US
Practice Address - Phone:954-404-4633
Practice Address - Fax:954-616-5773
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN71021223E0200X
FL71021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics