Active NPI
William L Drake Jr., DDS
- Dentist
- Brookneal, VA
National Provider Identifier
1336150887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5958
- Practice address
- 258 Main St
Brookneal, VA 24528 - Phone
- (434) 376-2460
- NPI assigned
- Aug 10, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5958 | VA | Primary |
Addresses
Primary practice location
258 Main St
Brookneal, VA 24528
Mailing address
PO Box 610
258 Main St
Brookneal, VA 24528-0610
Phone (434) 376-2460
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5958 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336150887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 610",
"address_2": "258 MAIN ST",
"city": "BROOKNEAL",
"state": "VA",
"postal_code": "245280610",
"telephone_number": "434-376-2460",
"fax_number": "434-376-2644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 MAIN ST",
"city": "BROOKNEAL",
"state": "VA",
"postal_code": "24528",
"telephone_number": "434-376-2460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "WILLIAM",
"middle_name": "L",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "5958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookneal, VA
- Brookneal Life Care Corp
- Brookneal Optical, Inc
- Donald E. Carwile, M.D.
- Centra Health Professional Services, LLC (Brookneal Family Medical Center)
- Centra Medical Group, LLC (Centra Medical Group Brookneal)
- Dustin Keller Enterprises LLC
- Richard Lee Fisher Sr., DDS
- Cindy Juritus Hancock-Carden
- William G. Jones, M.D.
- Juritus United (Perfect Harmony)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.