Provider Demographics
NPI:1013926351
Name:WEININGER, DANIEL RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RAY
Last Name:WEININGER
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 1:249 FAIR AVE NW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-3735
Mailing Address - Country:US
Mailing Address - Phone:330-339-6414
Mailing Address - Fax:330-339-2255
Practice Address - Street 1:249 FAIR AVE NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-3735
Practice Address - Country:US
Practice Address - Phone:330-339-6414
Practice Address - Fax:330-339-2255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice