DWC-J, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

GA 10747 Issued in GA

Legal business name

DWC-J, LLC

Practice address

135 Peachtree St
Jesup, GA 31545-0211

Phone

(912) 665-2792

Fax

(888) 289-4301

NPI assigned

Jul 14, 2011

Organization subpart

Yes

Parent organization

WHTDMD, LLCAs reported in NPPES

Name

Dr. William Howard Trout Jr., DMD

Title

Managing Partner

Phone

(912) 665-2792

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Whtdmd,LLC

  • Dentist
  • Richmond Hill, GA
  • NPI 1669788808
  NPPES parent name

Part of

Whtdmdllc

Locations

• Dental Wellness Center of Jesup Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 14, 2011.

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1538457387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450211",
            "telephone_number": "912-665-2792",
            "fax_number": "888-289-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450211",
            "telephone_number": "912-665-2792",
            "fax_number": "888-289-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWC-J, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHTDMD, LLC",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "TROUT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "912-665-2792",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "GA",
            "license": "GA 10747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Wellness Center of Jesup",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Jesup, GA
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.