William S Staten, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

11165 Issued in FL

Practice address

1250 Southwinds Dr
Pbcph - Lantana Health Center Dental Clinic
Lantana, FL 33462-1459

Phone

(561) 547-6811

Fax

(561) 540-1107

NPI assigned

Sep 1, 2006

Last updated

Jan 31, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1114029170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W INDIAN CROSSING CIR",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585276",
            "telephone_number": "561-630-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 SOUTHWINDS DR",
            "address_2": "PBCPH - LANTANA HEALTH CENTER DENTAL CLINIC",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334621459",
            "telephone_number": "561-547-6811",
            "fax_number": "561-540-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "11165",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "11165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0736431-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in Lantana, FL
• Providers in Lantana, FL by specialty
• Public Health Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.