Individual provider Active NPI

William Tyler Heath, D.M.D.

  • General Practice Dentistry
  • Rayville, LA
National Provider Identifier
1609811124
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5110 Issued in LA
Practice address
1107 Louisa St
Rayville, LA 71269-2925
Phone
(318) 728-9585
Fax
(318) 728-9595
NPI assigned
Jun 18, 2006
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5110 LA Primary

Addresses

Primary practice location

1107 Louisa St
Rayville, LA 71269-2925

Mailing address

1107 Louisa St
Rayville, LA 71269-2925
Phone (318) 728-9585

Other identifiers 1

IdentifierTypeStateIssuer
1851108MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5110LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
W. Tyler Heath, D.M.D., Family Dentistry a Dent General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1609811124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 LOUISA ST",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712692925",
            "telephone_number": "318-728-9585",
            "fax_number": "318-728-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 LOUISA ST",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712692925",
            "telephone_number": "318-728-9585",
            "fax_number": "318-728-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "WILLIAM",
        "middle_name": "TYLER",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851108",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rayville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.