Provider Demographics
NPI:1598724825
Name:KAPLAN, RICHARD WAYNE (MD,DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WAYNE
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD,DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 BOMAR DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3006
Mailing Address - Country:US
Mailing Address - Phone:561-848-0553
Mailing Address - Fax:561-420-0151
Practice Address - Street 1:1951 BOMAR DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33408-3006
Practice Address - Country:US
Practice Address - Phone:561-848-0553
Practice Address - Fax:561-420-0151
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN116251223S0112X
FLME61080174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL073664301Medicaid
FLU21359Medicare UPIN
FL073664301Medicaid