Glen Robert Watkinson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02048603 Issued in NJ

Practice address

236 Ernston Rd
Suite 6
Parlin, NJ 08859-1926

Phone

(732) 525-0049

Fax

(732) 525-0089

NPI assigned

May 1, 2007

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 NJ

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

Practice roles

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.

• K&W Family Dental, LLC

  • General Practice Dentistry
  • Parlin, NJ
  • NPI 1043438674
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407076490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SOUTHWOOD DR",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571452",
            "telephone_number": "732-390-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 ERNSTON RD",
            "address_2": "SUITE 6",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088591926",
            "telephone_number": "732-525-0049",
            "fax_number": "732-525-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINSON",
        "first_name": "GLEN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02048603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Venti Tile Inc
• Alison Vivenzio, PT, DPT
• VT Exquisite Home Care
• David Edmond Waits, MS, ATC
• Walgreen Co
• Michael P Weidman, PT, DPT
• Wellness & Motion LLC
• Nicolette Concetta Wescott, LSW
• Yana White, PHARMACIST
• Maneth L Wijerathne

• General Practice Dentistry in Parlin, NJ
• Providers in Parlin, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.
• 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.