Individual provider Active NPI

William Wayne Carmichael, DMD

  • General Practice Dentistry
  • Fort Gordon, GA
National Provider Identifier
1669456828
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401006643 Issued in VA
Practice address
BLDG 38717 38 St.
Attn: Credentials Office
Ft Gordon, GA 30905-5660
Phone
(706) 787-6927
Fax
(706) 787-2082
NPI assigned
Dec 1, 2005
Last updated
Aug 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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 0401006643 VA Primary

Addresses

Primary practice location

BLDG 38717 38 St.
Attn: Credentials Office
Ft Gordon, GA 30905-5660

Mailing address

BLDG 38717 38 St.
Attn: Credentials Office
Ft Gordon, GA 30905-5660
Phone (706) 787-6927

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
0401006643VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1669456828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 38717 38 ST.",
            "address_2": "ATTN: CREDENTIALS OFFICE",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 38717 38 ST.",
            "address_2": "ATTN: CREDENTIALS OFFICE",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "WILLIAM",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gordon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.