Active NPI
Renee E Watts, DDS
- General Practice Dentistry
- Springfield, OR
National Provider Identifier
1568469393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D7573
- Practice address
- 1040 Gateway Loop Ste B
Springfield, OR 97477-1196 - Phone
- (541) 465-9821
- Fax
- (541) 988-1825
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D7573 | OR | Primary |
Addresses
Primary practice location
1040 Gateway Loop Ste B
Springfield, OR 97477-1196
Mailing address
498 Harlow Rd
Suite 1
Springfield, OR 97477-1336
Phone (541) 465-9821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150729007495 | OR | Order and Referring Only - Oral Surgery | 2163605965 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7573 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Renee E Watts DDS PC | Current | Accepting new patients |
Locations
498 Harlow Rd
Ste 1
Springfield, OR 97477
Phone (541) 465-9821
1040 Gateway Loop
Ste B
Springfield, OR 97477
Phone (541) 465-9821
Organizations & group practices 1
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": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1568469393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "498 HARLOW RD",
"address_2": "SUITE 1",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974771336",
"telephone_number": "541-465-9821",
"fax_number": "541-988-1825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 GATEWAY LOOP STE B",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974771196",
"telephone_number": "541-465-9821",
"fax_number": "541-988-1825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "RENEE",
"middle_name": "E",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D7573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.