Wayland M Watts III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN14963 Issued in FL

Practice address

1389 S Patrick Dr
BLDG 1371
Patrick AFB, FL 32925-3607

Phone

(321) 494-6366

NPI assigned

Jan 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386799880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411145",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329411145",
            "telephone_number": "321-591-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1389 S PATRICK DR",
            "address_2": "BLDG 1371",
            "city": "PATRICK AFB",
            "state": "FL",
            "postal_code": "329253607",
            "telephone_number": "321-494-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "WAYLAND",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Nicole Tipton
• Denise Torres Garcia, PHYSICIAN ASSISTANT
• David Valentine, PHARMD
• Joella Louise Walker
• Katherine Ross Warrick, LCSW
• Dawn L Werner, O.D.
• Marie Wilson-Marshall, MD
• Amber Shalise Wofford
• Maria Del Pilar Woods, FNP
• Xiao Dan Zeng, PSY.D.

• General Practice Dentistry in Patrick AFB, FL
• Providers in Patrick AFB, FL by specialty
• General Practice Dentistry in Florida

• 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.

Verify at the official NPI Registry.