Tom C Watson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DSO-27446-L Issued in PA

Practice address

39 N Sproul Rd
Broomall, PA 19008-2512

Phone

(610) 356-8011

Fax

(610) 356-3020

NPI assigned

Oct 16, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 23, 2019 through Jul 23, 2027

Medicare enrollment (NPD)

Not 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.

• Broomall Dental Health PC

  • General Practice Dentistry
  • Broomall, PA
  • NPI 1952744260
  NPD (past) Authorized official

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1528148384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 N SPROUL RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082512",
            "telephone_number": "610-356-8011",
            "fax_number": "610-356-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 N SPROUL RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082512",
            "telephone_number": "610-356-8011",
            "fax_number": "610-356-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TOM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DSO-27446-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Elaine Walker, M.D.
• Shaunise S Walker
• Akeesha M Washington
• April D Washington
• Kayla R Watson, RBT
• William A Wegener, MD
• Hanna Chaya Weintraub, OTR/L, CLT
• Karen Weiss, LSW
• Melissa Vanderwolf Weldon, LCSW-C
• Bridgett Wendel, PHARMD

• General Practice Dentistry in Broomall, PA
• Providers in Broomall, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.