Provider Demographics
NPI:1770697948
Name:WAITE, GINA DAWN (DDS)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:DAWN
Last Name:WAITE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 NORTH 37TH STREET
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701
Mailing Address - Country:US
Mailing Address - Phone:402-371-0852
Mailing Address - Fax:402-371-0928
Practice Address - Street 1:110 NORTH 37TH STREET
Practice Address - Street 2:SUITE 401
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701
Practice Address - Country:US
Practice Address - Phone:402-371-0852
Practice Address - Fax:402-371-0928
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE61881223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025152900Medicaid