Provider Demographics
NPI:1669149985
Name:ANNA VAYSMAN DMD PLLC
Entity type:Organization
Organization Name:ANNA VAYSMAN DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAYSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-451-0908
Mailing Address - Street 1:9755 N 90TH ST STE 190
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5047
Mailing Address - Country:US
Mailing Address - Phone:480-451-0908
Mailing Address - Fax:480-451-8169
Practice Address - Street 1:9755 N 90TH ST STE 190
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5047
Practice Address - Country:US
Practice Address - Phone:480-451-0908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty