Provider Demographics
NPI:1134194392
Name:WOLPIN, SCOTT BRIAN (DMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BRIAN
Last Name:WOLPIN
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 1:20280 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ONANCOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417-1331
Mailing Address - Country:US
Mailing Address - Phone:757-414-0400
Mailing Address - Fax:757-414-0569
Practice Address - Street 1:5219 LANKFORD HWY
Practice Address - Street 2:
Practice Address - City:NEW CHURCH
Practice Address - State:VA
Practice Address - Zip Code:23415-3332
Practice Address - Country:US
Practice Address - Phone:757-824-5676
Practice Address - Fax:757-824-5872
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10430122300000X
VA0401414210122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD36381OtherPRIORITY PARTNERS
MD0013670OtherDORAL DENTAL
MD000955013OtherUNITED CONCORDIA
MD5434240OtherAETNA
MD822105700Medicaid
MD10430OtherDELTA DENTAL
MD959951OtherDENTAL BENEFIT PROVIDERS
MD61187701OtherCAREFIRST BC/BS DENTAL