Individual provider Active NPI

Ronan Patrick Waterson, DDS

  • General Practice Dentistry
  • Parsons, KS
National Provider Identifier
1104759042
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62363 Issued in KS
Practice address
2300 Main St
Parsons, KS 67357-2724
Phone
(620) 421-4940
Fax
(620) 421-4941
NPI assigned
Jun 8, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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 62363 KS Primary

Addresses

Primary practice location

2300 Main St
Parsons, KS 67357-2724

Mailing address

2300 Main St
Parsons, KS 67357-2724
Phone (620) 421-4940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Parsons Family Dentistry, LLC PastSince Aug 11, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1780876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1104759042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MAIN ST",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673572724",
            "telephone_number": "620-421-4940",
            "fax_number": "620-421-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MAIN ST",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673572724",
            "telephone_number": "620-421-4940",
            "fax_number": "620-421-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERSON",
        "first_name": "RONAN",
        "middle_name": "PATRICK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "62363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsons, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.