Organization Active NPI

David Woolston DDS PLLC

Doing business as Webber Dentistry

  • Dental Clinic/Center
  • Charlotte, NC
National Provider Identifier
1194481051
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DAVID WOOLSTON DDS PLLC
Doing business as
Webber Dentistry
Practice address
2120 Dr Webber Ave
Charlotte, NC 28216-4898
Phone
(704) 392-9357
NPI assigned
Nov 15, 2021
Last updated
Nov 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Authorized official

Name
Mr. Ronald Daniel Serrao
Title
Chief Operations Officer
Phone
(980) 316-7102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

2120 Dr Webber Ave
Charlotte, NC 28216-4898

Mailing address

2120 Dr Webber Ave
Charlotte, NC 28216-4898
Phone (704) 392-9357

Other identifiers 1

IdentifierTypeStateIssuer
899533MedicaidNC

Other names 1

  • Webber Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1194481051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 DR WEBBER AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164898",
            "telephone_number": "704-392-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 DR WEBBER AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282164898",
            "telephone_number": "704-392-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID WOOLSTON DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "SERRAO",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "980-316-7102",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899533",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Webber Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.