Active NPI
William Todd Hegmann, DDS, MS
- General Practice Dentistry
- Texarkana, TX
National Provider Identifier
1265630677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 28558
- 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, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3907 | AR | MD | General Practice Dentistry |
| 28558 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Dental Center of Texarkana PLLC | Past | 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.
-
dba Eagle Dental Center PLLC
- Dentist
- Texarkana, TX
- NPI 1134540628
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.