Individual provider Active NPI

William Todd Hegmann, DDS, MS

  • General Practice Dentistry
  • Texarkana, TX
National Provider Identifier
1265630677
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28558 Issued in TX
Practice address
4410 Texas Blvd
Texarkana, TX 75503-3015
Phone
(903) 794-9974
Fax
(903) 793-6067
NPI assigned
Jul 6, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3907 AR
General Practice Dentistry 1223G0001X 28558 TX Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3716 WV

Addresses

Primary practice location

4410 Texas Blvd
Texarkana, TX 75503-3015

Mailing address

4410 Texas Blvd
Texarkana, TX 75503-3015
Phone (903) 794-9974

Other practice location 1

1015 E 35th St
Texarkana, AR 71854-2745
Phone (870) 773-3119

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3907ARMDGeneral Practice Dentistry
28558TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Dental Center of Texarkana PLLC PastSince Jun 7, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1265630677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033015",
            "telephone_number": "903-794-9974",
            "fax_number": "903-793-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033015",
            "telephone_number": "903-794-9974",
            "fax_number": "903-793-6067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 E 35th St",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "AR",
            "postal_code": "718542745",
            "country_code": "US",
            "telephone_number": "870-773-3119",
            "fax_number": "870-772-7347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEGMANN",
        "first_name": "WILLIAM",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3907",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28558",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "3716",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.