Active NPI
Stenson Womack, DMD
- General Practice Dentistry
- Jackson, CA
National Provider Identifier
1679094007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 101457
- Practice address
- 511 Sutter St
Jackson, CA 95642-2004 - Phone
- (209) 223-0204
- NPI assigned
- Jul 7, 2017
- Last updated
- Jul 7, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 101457 | CA | Primary |
Addresses
Primary practice location
511 Sutter St
Jackson, CA 95642-2004
Mailing address
511 Sutter St
Jackson, CA 95642-2004
Phone (209) 223-0204
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
| License | State | Type | Specialty |
|---|---|---|---|
| 101457 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Womack Dental DMD Inc | Current | Accepting new patients |
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": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499385600000",
"number": "1679094007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 SUTTER ST",
"city": "JACKSON",
"state": "CA",
"postal_code": "956422004",
"telephone_number": "209-223-0204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 SUTTER ST",
"city": "JACKSON",
"state": "CA",
"postal_code": "956422004",
"telephone_number": "209-223-0204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMACK",
"first_name": "STENSON",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-07",
"last_updated": "2017-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "101457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.