Individual provider Active NPI

David E Woolston, DDS

  • General Practice Dentistry
  • Fort Mill, SC
National Provider Identifier
1023103629
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6405 Issued in NC
Practice address
1075 Market St
Fort Mill, SC 29708-6496
Phone
(919) 802-2131
NPI assigned
Oct 3, 2006
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6405 NC Primary

Addresses

Primary practice location

1075 Market St
Fort Mill, SC 29708-6496

Mailing address

1075 Market St
Fort Mill, SC 29708-6496
Phone (919) 802-2131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160802000412 SC Order and Referring Only - DentistPractitioner - Dentist 4587957378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6405NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Colonel Dental Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1023103629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 MARKET ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086496",
            "telephone_number": "919-802-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 MARKET ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086496",
            "telephone_number": "919-802-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLSTON",
        "first_name": "DAVID",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

Verify at the official NPI Registry.