Easley, Wayland Antonio
Easley, Wayland Antonio is an individual health care provider with primary practice located at 40 Toll Gate Rd , Warwick RI 02886-4444. He recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Allopathic & Osteopathic Physicians / Anesthesiology, Dental Providers / Oral and Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Easley, Wayland Antonio can be contacted via phone (401) 749-2345.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DEN02883 | Rhode Island |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | DAPA02663 | Rhode Island |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 2130220 | Massachusetts |
| Dental Providers / Dentist | 122300000X | 21302 | Massachusetts |
| Dental Providers / Dentist | 122300000X | 051644 | New York |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 0223000 MASSHEALTH | Massachusetts |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 0223000 DORAL DENTAL | Massachusetts |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | AGHDREXEL OMS | Pennsylvania |
Profile Details
| NPI number | 1770780645 |
|---|---|
| LBN Legal business name | Easley, Wayland Antonio |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2007 |
| Last updated | Oct 12th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770780645 | NPPES |
| Rhode Island | MEDICAID | WE57613 | |
| Rhode Island | Other | 0223000 | |
| Rhode Island | MEDICAID | 0223000 |
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