Jeffrey Kent Waters, D.M.D., M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN013125 Issued in GA

Practice address

2680 Lawrenceville Hwy
Suite 102
Decatur, GA 30033-2500

Phone

(678) 990-8034

Fax

(770) 934-7176

NPI assigned

Apr 16, 2008

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

Medicare fee-for-service enrollment

Enrolled in GA

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

Credentials

Master of Science

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.

• Jeffrey K Waters D.M.D., P.C

  • Endodontics
  • Decatur, GA
  • NPI 1396933792
  NPD (past) Authorized official

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1245404714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY",
            "address_2": "SUITE 102",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332500",
            "telephone_number": "678-990-8034",
            "fax_number": "770-934-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY",
            "address_2": "SUITE 102",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332500",
            "telephone_number": "678-990-8034",
            "fax_number": "770-934-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "JEFFREY",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN013125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline McFarland Washington, MD
• Kalia Monique Washington
• Lance Timothy Washington
• Marcus Washington, LCSW
• Monique Washington
• Berdell Elizabeth Watkins, AG ACNP
• Crystal Watkins, MS, LPC, LMHC
• Jasper W Watkins III, BPHARM
• Chancy Watson
• Charlisa Watson, LCSW

• Endodontics in Decatur, GA
• Providers in Decatur, GA by specialty
• Endodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.