C.W. Uriah Edmondson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

111304 Issued in CA

Practice address

73666 Joshua Dr
Twentynine Palms, CA 92277-2572

Phone

(301) 742-4079

NPI assigned

Feb 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cedmondson807550@direct.ochin.org

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.

• Edmondson Dental Center for Maryland Public Health, Inc

  • General Practice Dentistry
  • Grantsville, MD
  • NPI 1821384314
  NPD (past) Authorized official

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1497727754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SIMONTON CREST DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453509",
            "telephone_number": "301-742-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73666 JOSHUA DR",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922772572",
            "telephone_number": "301-742-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "C.W.",
        "middle_name": "URIAH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13821",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4237",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "111304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810021389",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039320700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Grace Dixon, PA-C
• Mikhailpietro Drilon
• Brandon C Dugar, D.O.
• David James Dyer, D.D.S.
• Phyllis Jo Ann Dykes, RN, MSN, PMHCNS
• Philip J Efthemis, DPT
• Elite Behavioral Solutions LLC
• Alice Jo Elmer
• Jay Erickson, MD
• Faith Home Healthcare LLC

• General Practice Dentistry in Twentynine Palms, CA
• Providers in Twentynine Palms, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.