Provider Demographics
NPI:1922121755
Name:WAZNEY, JOHN LEONARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEONARD
Last Name:WAZNEY
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 1:32001 VINE ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-3572
Mailing Address - Country:US
Mailing Address - Phone:440-944-3000
Mailing Address - Fax:440-944-0881
Practice Address - Street 1:32001 VINE ST
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-3572
Practice Address - Country:US
Practice Address - Phone:440-944-3000
Practice Address - Fax:440-944-0881
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH161251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice