John S Weaver, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00005111 Issued in WA

Practice address

3641 Ensign Rd NE Ste 6a
Olympia, WA 98506-5046

Phone

(360) 915-6321

Fax

(360) 489-1748

NPI assigned

Nov 29, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1508933946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 ENSIGN RD NE STE 6A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065046",
            "telephone_number": "360-915-6321",
            "fax_number": "360-489-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 ENSIGN RD NE STE 6A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065046",
            "telephone_number": "360-915-6321",
            "fax_number": "360-489-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00005111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I PROVIDER NUMBER",
            "identifier": "0035126",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "000843827",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5550603",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Wathne, LICSW
• Angus Watson, M.D.
• Joahna Watson
• Richard Allen Watts
• Lauren Rebecca Waxwing
• Angie Lee Webb
• Melanie S Webb, ARNP
• Seth Webb, DNP PNP
• Britni Ann Webber, LMP
• Charles R Weber, DMD

• General Practice Dentistry in Olympia, WA
• Providers in Olympia, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.