Provider Demographics
NPI:1558389551
Name:WALDMAN, GENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:
Last Name:WALDMAN
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 1:3220 NEWPORT CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3617
Mailing Address - Country:US
Mailing Address - Phone:925-943-1837
Mailing Address - Fax:510-832-1542
Practice Address - Street 1:1708 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3408
Practice Address - Country:US
Practice Address - Phone:510-893-3611
Practice Address - Fax:510-832-1542
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA270811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice