Provider Demographics
NPI:1770992166
Name:WEINSTEIN, JOSHUA (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:WEINSTEIN
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 1:4861 LOGISTICS AVE. BLDG H-
Mailing Address - Street 2:
Mailing Address - City:FT. BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28210
Mailing Address - Country:US
Mailing Address - Phone:910-907-1076
Mailing Address - Fax:
Practice Address - Street 1:4861 LOGISTIC AVE. BLDG H-
Practice Address - Street 2:
Practice Address - City:FT. BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28210
Practice Address - Country:US
Practice Address - Phone:910-907-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9116864-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist