Individual provider Active NPI

Joshua C Willard, D.M.D.

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1619137833
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27858 Issued in TX
Practice address
5425 W Spring Creek Pkwy
162
Plano, TX 75024-4236
Phone
(972) 964-1855
Fax
(972) 943-9301
NPI assigned
Jun 11, 2008
Last updated
Jan 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1261 AK
General Practice Dentistry 1223G0001X 27858 TX Primary

Addresses

Primary practice location

5425 W Spring Creek Pkwy
162
Plano, TX 75024-4236

Mailing address

3721 Woodmont CT
Bedford, TX 76021-2330
Phone (817) 437-6139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160315000016 TX Order and Referring Only - DentistPractitioner - Dentist 3577869726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27858TXMDLicensed Vocational Nurse
1261AKMDPediatric Physical Therapist

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1619137833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 WOODMONT CT",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760212330",
            "telephone_number": "817-437-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY",
            "address_2": "162",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244236",
            "telephone_number": "972-964-1855",
            "fax_number": "972-943-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JOSHUA",
        "middle_name": "C",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1261",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.