Individual provider Active NPI

William Jason McDaniel III, D.D.S.

  • General Practice Dentistry
  • Raleigh, NC
National Provider Identifier
1285828772
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6843 Issued in NC
Practice address
7509 Six Forks Rd
Raleigh, NC 27615-5020
Phone
(919) 847-5959
Fax
(919) 844-9341
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6843 NC Primary

Addresses

Primary practice location

7509 Six Forks Rd
Raleigh, NC 27615-5020

Mailing address

7509 Six Forks Rd
Raleigh, NC 27615-5020
Phone (919) 847-5959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20200629000117 NC Order and Referring Only - DentistPractitioner - Dentist 6608298260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1285828772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7509 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155020",
            "telephone_number": "919-847-5959",
            "fax_number": "919-844-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7509 SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155020",
            "telephone_number": "919-847-5959",
            "fax_number": "919-844-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "WILLIAM",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.