NPIMap

Organization Active NPI

Watson PSC Dba West Louisville Dental Center

  • Dentist
  • Louisville, KY
National Provider Identifier
1629197892
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WATSON PSC DBA WEST LOUISVILLE DENTAL CENTER
Practice address
2500 W Broadway
Louisville, KY 40211-1081
Phone
(502) 776-1754
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Authorized official

Name
Dr. Kwane Mitchell Watson, D.M.D.
Title
Owner
Phone
(502) 776-1754

Specialties & licenses 1

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

Addresses

Primary practice location

2500 W Broadway
Louisville, KY 40211-1081

Mailing address

2500 W Broadway
Louisville, KY 40211-1081
Phone (502) 776-1754

National Provider Directory

National Provider Directory
Tax ID family
Watson PSC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1629197892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111081",
            "telephone_number": "502-776-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111081",
            "telephone_number": "502-776-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATSON PSC DBA WEST LOUISVILLE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2010-09-01",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "KWANE",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-776-1754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.