Theron Waisath, DMD
Oral & Maxillofacial Surgery · Champaign, IL
UnclaimedDMDNPI 1144423963
- Primary taxonomy
- 1223S0112X
- Enumerated
- 2007-06-08
- Practice location
- Champaign, IL
- Last NPPES update
- 2009-07-23
State licenses
- IL · Dentist · LICENSED DENTISTActivethrough 2027
- IL · Dentist · LICENSED SPECIALIST IN DENTISTRYActivethrough 2027
- OH · Dentist · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.