Active NPI
Joshua C Willard, D.M.D.
- General Practice Dentistry
- Plano, TX
National Provider Identifier
1619137833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 27858
- 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, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160315000016 | TX | Order and Referring Only - Dentist | 3577869726 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27858 | TX | MD | Licensed Vocational Nurse |
| 1261 | AK | MD | Pediatric 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.