William G Bumgarner, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN008602 Issued in GA

Practice address

6770 Selman Dr
Douglasville, GA 30134-1756

Phone

(770) 949-7359

NPI assigned

Dec 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1578745162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6770 SELMAN DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341756",
            "telephone_number": "770-949-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 SELMAN DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341756",
            "telephone_number": "770-949-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARNER",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "GA",
            "license": "DN008602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000153414F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9208296",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000153414E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "102300",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Buckley
• Rosalind Buckner
• Tri Bui, RPH
• Cory Buice, DPT
• Raeonda Bullard, MD
• Kenneth Desmond Bunn, D.M.D.
• Gina Marie Burbank, FNP-C
• Jessica Burger, RBT
• Gabrielle Marie Burholt, MA, NCC, LAPC
• Christopher Michael Burket, MD

• Public Health Dentistry in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Public Health Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.

Verify at the official NPI Registry.