Provider Demographics
NPI:1548459399
Name:WEIKUM, DONALD GENE (DDS)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:GENE
Last Name:WEIKUM
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 1:185 N FROST DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5742
Mailing Address - Country:US
Mailing Address - Phone:989-792-6621
Mailing Address - Fax:989-792-6899
Practice Address - Street 1:185 N FROST DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5742
Practice Address - Country:US
Practice Address - Phone:989-792-6621
Practice Address - Fax:989-792-6899
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010107521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice