Provider Demographics
NPI:1790978724
Name:WAINGER, JULES MELVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULES
Middle Name:MELVIN
Last Name:WAINGER
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 1:281 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2986
Mailing Address - Country:US
Mailing Address - Phone:757-499-9639
Mailing Address - Fax:757-490-0808
Practice Address - Street 1:281 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2986
Practice Address - Country:US
Practice Address - Phone:757-499-9639
Practice Address - Fax:757-490-0808
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA03299122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist