Provider Demographics
NPI:1922109644
Name:WINGFIELD, STEVEN JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAMES
Last Name:WINGFIELD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 PEACHTREE RD NW
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-4915
Mailing Address - Country:US
Mailing Address - Phone:404-261-0909
Mailing Address - Fax:
Practice Address - Street 1:2900 PEACHTREE RD NW
Practice Address - Street 2:SUITE 209
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-4915
Practice Address - Country:US
Practice Address - Phone:404-261-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN012870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist