Provider Demographics
NPI:1609034982
Name:WINFEY, WALTER ALLEN (DDS)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:ALLEN
Last Name:WINFEY
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 1:3300 EL CAMINO AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-6308
Mailing Address - Country:US
Mailing Address - Phone:916-486-1505
Mailing Address - Fax:916-486-3548
Practice Address - Street 1:3300 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6308
Practice Address - Country:US
Practice Address - Phone:916-486-1505
Practice Address - Fax:916-486-3548
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36448122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist