William Joel Newsom III, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

10350 Issued in GA

Practice address

200 Market Place Suite 120
Roswell, GA 30075-3989

Phone

(770) 998-0030

Fax

(770) 650-0424

NPI assigned

Apr 2, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1316119092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARKET PLACE SUITE 120",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753989",
            "telephone_number": "770-998-0030",
            "fax_number": "770-650-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MARKET PLACE SUITE 120",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753989",
            "telephone_number": "770-998-0030",
            "fax_number": "770-650-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOM",
        "first_name": "WILLIAM",
        "middle_name": "JOEL",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "10350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Roswell, GA
• Providers in Roswell, GA by specialty
• Endodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.

Verify at the official NPI Registry.