Individual provider Active NPI

William B Parker, D.D.S.

  • Periodontics
  • Fort Lauderdale, FL
National Provider Identifier
1174506745
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
480 Issued in FL
Practice address
3200 South University Drive
Nsu College of Dental Medicine Dept of Periodontology
Fort Lauderdale, FL 33328
Phone
(954) 262-7330
Fax
(954) 262-1782
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401008175 VA
Periodontics 1223P0300X 480 FL Primary

Addresses

Primary practice location

3200 South University Drive
Nsu College of Dental Medicine Dept of Periodontology
Fort Lauderdale, FL 33328

Mailing address

3200 South University Drive
Nsu College of Dental Medicine Dept of Periodontology
Fort Lauderdale, FL 33328
Phone (954) 262-7330

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

State licenses

LicenseStateTypeSpecialty
480FLMDPeriodontist
0401008175VAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1174506745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SOUTH UNIVERSITY DRIVE",
            "address_2": "NSU COLLEGE OF DENTAL MEDICINE DEPT OF PERIODONTOLOGY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33328",
            "telephone_number": "954-262-7330",
            "fax_number": "954-262-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SOUTH UNIVERSITY DRIVE",
            "address_2": "NSU COLLEGE OF DENTAL MEDICINE DEPT OF PERIODONTOLOGY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33328",
            "telephone_number": "954-262-7330",
            "fax_number": "954-262-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401008175",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.