Will Umphlett, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

3854-16 Issued in MS

Practice address

22 Eastgate Dr
Brandon, MS 39042

Phone

(601) 825-1105

Fax

(601) 825-1984

NPI assigned

Jul 7, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• William Elliott Umphlett Professional name

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mayatte Family Dentistry, LLC

  • General Practice Dentistry
  • Brandon, MS
  • NPI 1316154776
  NPD (past)

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1669824280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 EASTGATE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422318",
            "telephone_number": "601-825-1105",
            "fax_number": "601-825-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 EASTGATE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39042",
            "telephone_number": "601-825-1105",
            "fax_number": "601-825-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMPHLETT",
        "first_name": "WILL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3854-16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "UMPHLETT",
            "middle_name": "ELLIOTT",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kayla Turner, SLP
• Pamela Turner, RN, RRT
• Sarah Chelsea Turner
• Albert Wayne Tutor Jr., D.M.D.
• Jeron Tyree
• Unified Prosthetics and Orthotics, LLC.
• Gracie A Upton
• Macy Renee Upton, NP
• Van Meter Oral Surgery, LLC
• Charles Jackson Van Meter III, DMD, MD

• Dentist in Brandon, MS
• Providers in Brandon, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.