Individual provider Active NPI

Edmund D.a Watkins, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Houston, TX
National Provider Identifier
1497901862
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
23027 Issued in TX
Practice address
10139 Hammerly Blvd
Houston, TX 77080
Phone
(713) 465-0099
Fax
(713) 465-0094
NPI assigned
Aug 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 23027 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 23027 TX Primary

Addresses

Primary practice location

10139 Hammerly Blvd
Houston, TX 77080

Mailing address

10139 Hammerly Blvd
Houston, TX 77080
Phone (713) 465-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20120702000103 TX Practitioner - Oral Surgery 0840455507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Meharry Medical College School of Dentistry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

5151 Maple Ave
Dallas, TX 75235-8136
Phone (214) 266-3333

5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone (214) 590-5582

5201 Harry Hines VLVD
Dallas, TX 75235-7708
Phone (214) 590-5582

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23027TXMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 11, 2011 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 11, 2011 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
NK Dental, P.a. Oral and Maxillofacial Surgery Past Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1218931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1497901862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10139 HAMMERLY BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77080",
            "telephone_number": "713-465-0099",
            "fax_number": "713-465-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10139 HAMMERLY BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77080",
            "telephone_number": "713-465-0099",
            "fax_number": "713-465-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "EDMUND",
        "middle_name": "D.A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-17",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23027",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.