DR. WAYNERD BERNARD FREDERICKSON II (NPI# 1750669420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750669420 |
| Entity Type | Individual |
| Full Name | DR. WAYNERD BERNARD FREDERICKSON II |
| Credential | D.D.S. |
| Practice Address |
9140 S Federal Hwy Port St Lucie FL 34952-3485 |
| Mailing Address |
17694 Cadena Dr Boca Raton FL 33496-1066 |
| Practice Telephone | 7723987790 |
| Practice Fax Number | 7723987796 |
| Mailing Telephone | 6304181620 |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2019-10-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 019-028665 | IL | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN23167 | FL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10196 W Sample Rd, Coral Springs, FL 33065 | 9547524450 | |
| 1300 W 2nd St, Rock Falls, IL 610711005 | 8156262230 | 8156266339 |
| 2860 S Seacrest Blvd, Boynton Beach, FL 334357935 | 5617322711 |
| Street Address |
9140 S FEDERAL HWY |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34952-3485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457664229 | Daniel M Fenton | Dentist | 9140 S Federal Hwy, Port St Lucie, FL 34952-3485 | 2010-07-21 |
| 1821519240 | Kaleb Edward Harp | Dentist | 9140 S Federal Hwy, Port St Lucie, FL 34952-3485 | 2017-07-06 |
| 1295194579 | Affordable Dentures - Port St. Lucie IIi, P.a. | Dentist | 9140 S Federal Hwy, Port St Lucie, FL 34952-3485 | 2016-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215587068 | Carehere LLC | Family Medicine | Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 | 2019-09-13 |
| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
| Find all providers in zip 34952 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811482656 | Chi Nguyen | Dentist | 1100 Sw Saint Lucie West Blvd Ste 206, Port St Lucie, FL 34986-1735 | 2018-06-25 |
| 1801304977 | Tradition Dental, P.a. | Dentist | 1973 Sw Savage Blvd Ste 205, Port St Lucie, FL 34953-2791 | 2018-01-11 |
| 1427568195 | Kevin A Jones | Dentist | 1384 Sw Saint Lucie West Blvd, Port St Lucie, FL 34986-2109 | 2017-10-06 |
| 1053849919 | Kerry D Aston | Dentist | 499 Nw Prima Vista Blvd Unit 107, Port St Lucie, FL 34983-8786 | 2017-05-23 |
| 1366975575 | Comfortable Care Dental Health Professionals, Pa | Dentist | 10670 Sw Tradition Pkwy, Port St Lucie, FL 34987-2862 | 2017-04-05 |
| 1548432321 | Ronald Craig Cusato | Dentist | 316 Nw Bethany Dr, Port St Lucie, FL 34986-3578 | 2008-04-01 |
| 1932397536 | Christopher Lawrence Petterson | Dentist | 10157 S Federal Hwy, Port St Lucie, FL 34952-5609 | 2007-10-09 |
| 1043426778 | Brian Marti Kusel | Dentist | 491 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-2044 | 2007-05-16 |
| 1720290455 | Ryan Ellis Askeland | Dentist | 421 Sw Bethany Dr, Port St Lucie, FL 34986-2136 | 2007-05-04 |
| 1851414056 | John S Cairns | Dentist | 1343 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5366 | 2007-04-10 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34952 |
Please comment or provide details below to improve the information on DR. WAYNERD BERNARD FREDERICKSON II.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.