Active NPI
William Andrew Pack, D.D.S.
- Endodontics
- Midland, TX
National Provider Identifier
1295997807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 26390
- Practice address
- 3001 W Illinois Ave
Suite 1B1
Midland, TX 79701-3180 - Phone
- (432) 689-2006
- NPI assigned
- Jun 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 26390 | TX | Primary |
| Endodontics | 1223E0200X | 9009 | NC |
Addresses
Primary practice location
3001 W Illinois Ave
Suite 1B1
Midland, TX 79701-3180
Mailing address
3001 W Illinois Ave
Suite 1B1
Midland, TX 79701-3180
Phone (432) 689-2006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26390 | TX | MD | Endodontist |
| 9009 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watonga Indian Health Center | Current | Accepting new patients | |
| El Reno Indian Health Center | Current | Accepting new patients | |
| Clinton Indian Health Center | Current | Accepting new patients | |
| Midland Endodontics PC | Endodontics | Past | Accepting new patients |
Locations
10321 N 2274 Rd
Clinton, OK 73601
Phone (580) 331-3300
1801 Parkview Dr
El Reno, OK 73036
Phone (405) 234-5600
1305 S Clarence Nash Blvd
Watonga, OK 73772
Phone (580) 623-4991
Organizations & group practices 4
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.
-
- Endodontics
- Midland, TX
- NPI 1629480611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1295997807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 W ILLINOIS AVE",
"address_2": "SUITE 1B1",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797013180",
"telephone_number": "432-689-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 W ILLINOIS AVE",
"address_2": "SUITE 1B1",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797013180",
"telephone_number": "432-689-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACK",
"first_name": "WILLIAM",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-26",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "26390",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NC",
"license": "9009",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.