Individual provider Active NPI

David A Watson, D.D.S.

  • General Practice Dentistry
  • Paragould, AR
National Provider Identifier
1083787550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3163 Issued in AR
Practice address
628 W Garland St
Paragould, AR 72450-4213
Phone
(870) 236-1100
Fax
(870) 236-1106
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3163 AR Primary

Addresses

Primary practice location

628 W Garland St
Paragould, AR 72450-4213

Mailing address

628 W Garland St
Paragould, AR 72450-4213
Phone (870) 236-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160208000157 AR Order and Referring Only - DentistPractitioner - Dentist 5395049696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3163ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David Watson CurrentSince Jan 10, 2021 Accepting new patients

Locations

628 W Garland St
Paragould, AR 72450
Phone (870) 236-1100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083787550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 W GARLAND ST",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504213",
            "telephone_number": "870-236-1100",
            "fax_number": "870-236-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 W GARLAND ST",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504213",
            "telephone_number": "870-236-1100",
            "fax_number": "870-236-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.