William David Short, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

4403 Issued in NC

Practice address

1619 Live Oak St
Beaufort, NC 28516-1520

Phone

(252) 728-4570

NPI assigned

Jan 20, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• W. David Short, DMD, PA

  • General Practice Dentistry
  • Beaufort, NC
  • NPI 1487699930
  NPD (past)

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1194114751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 LIVE OAK ST",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161520",
            "telephone_number": "252-728-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 LIVE OAK ST",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161520",
            "telephone_number": "252-728-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-20",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "4403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-97787",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Wells Richter
• April M Risinger, P.A.
• Penny Ann Rule, L.AC
• Seaside Family Practice of Beaufort, Inc.
• Kelli Selfe, PHARMD
• Melissa B Smith
• Sound Nutrition Consulting, LLC
• Sound Pharmacy Services Inc
• Susan Hannula Stroup, ATC
• Linda Patterson Swain, DDS

• All providers in Beaufort, NC
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.