NPIMap

Organization Active NPI

Jamel McDuffie-Watson, DDS, PA

  • General Practice Dentistry
  • Durham, NC
National Provider Identifier
1255503728
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JAMEL MCDUFFIE-WATSON, DDS, PA
Practice address
6104 Fayetteville Rd
Suite 107
Durham, NC 27713-6283
Phone
(919) 484-7478
Fax
(919) 572-9942
NPI assigned
Mar 25, 2008
Last updated
Mar 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Dr. Jamel McDuffie-Watson, DDSNPI 1942387071
Title
President/Owner
Phone
(919) 484-7478

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6104 Fayetteville Rd
Suite 107
Durham, NC 27713-6283

Mailing address

6104 Fayetteville Rd
Suite 107
Durham, NC 27713-6283
Phone (919) 484-7478

Other identifiers 1

IdentifierTypeStateIssuer
899010WMedicaidNC

National Provider Directory

National Provider Directory

Locations

6104 Fayetteville Rd
Ste 107
Durham, NC 27713
Phone (919) 484-7478

Practitioners & affiliated clinicians

Practitioners 2

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": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1255503728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 FAYETTEVILLE RD",
            "address_2": "SUITE 107",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136283",
            "telephone_number": "919-484-7478",
            "fax_number": "919-572-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 FAYETTEVILLE RD",
            "address_2": "SUITE 107",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136283",
            "telephone_number": "919-484-7478",
            "fax_number": "919-572-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMEL MCDUFFIE-WATSON, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "MCDUFFIE-WATSON",
        "authorized_official_first_name": "JAMEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "919-484-7478",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899010W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.