Individual provider Active NPI

William Padge Dorne

  • General Practice Dentistry
  • Palm Coast, FL
National Provider Identifier
1619000254
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8146 Issued in FL
Practice address
105 Cypress Point Parkway
Suite a
Palm Coast, FL 32164
Phone
(386) 445-6677
NPI assigned
Mar 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 8146 FL Primary

Addresses

Primary practice location

105 Cypress Point Parkway
Suite a
Palm Coast, FL 32164

Mailing address

105 Cypress Point Parkway
Suite a
Palm Coast, FL 32164
Phone (386) 445-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330002342 FL Order and Referring Only - DentistPractitioner - Dentist 5395042717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8146FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cypress Point Dentistry P.a. 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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619000254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CYPRESS POINT PARKWAY",
            "address_2": "SUITE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32164",
            "telephone_number": "386-445-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CYPRESS POINT PARKWAY",
            "address_2": "SUITE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32164",
            "telephone_number": "386-445-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNE",
        "first_name": "WILLIAM",
        "middle_name": "PADGE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "8146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.