NPIMap

Organization Active NPI

Mary Ann Weatherford DDS, PA

  • Dentist
  • Wynne, AR
National Provider Identifier
1609025451
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3649 Issued in AR
Legal business name
MARY ANN WEATHERFORD DDS, PA
Practice address
620 Julia Ave E
Wynne, AR 72396-3504
Phone
(870) 238-2600
Fax
(870) 238-5522
NPI assigned
Sep 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Dr. Mary Ann Weatherford, DDS, PANPI 1881852499
Title
Dentist
Phone
(870) 697-2606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3649 AR Primary

Addresses

Primary practice location

620 Julia Ave E
Wynne, AR 72396-3504

Mailing address

PO Box 554
620 Julia
Wynne, AR 72396-0554
Phone (870) 238-2600

National Provider Directory

National Provider Directory

Locations

620 Julia Ave E
Wynne, AR 72396
Phone (870) 208-3115

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1609025451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 554",
            "address_2": "620 JULIA",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723960554",
            "telephone_number": "870-238-2600",
            "fax_number": "870-238-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JULIA AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963504",
            "telephone_number": "870-238-2600",
            "fax_number": "870-238-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN WEATHERFORD DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "WEATHERFORD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "870-697-2606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "3649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.