Active NPI
Guy Gerald Waldron Jr., DDS
- Dentist
- Longview, TX
National Provider Identifier
1710067434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16406
- Practice address
- 3010 HG Mosley
Longview, TX 75605 - Phone
- (903) 759-7196
- Fax
- (903) 759-7197
- NPI assigned
- Oct 17, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 16406 | TX | Primary |
Addresses
Primary practice location
3010 HG Mosley
Longview, TX 75605
Mailing address
3010 HG Mosley
Longview, TX 75605
Phone (903) 759-7196
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 |
|---|---|---|---|
| 16406 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartland Dental Care of Texas | Dentist | Past | 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": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710067434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 HG MOSLEY",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "75605",
"telephone_number": "903-759-7196",
"fax_number": "903-759-7197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 HG MOSLEY",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "75605",
"telephone_number": "903-759-7196",
"fax_number": "903-759-7197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRON",
"first_name": "GUY",
"middle_name": "GERALD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "16406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3828)
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0398)
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-4114)
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0399)
- Wal-Mart Stores Texas, LP (Vision Center 30-0398)
- Alison L Walgama, MD
- Jonathan Pierce Walgama, M.D.
- Walgreen Co (Walgreens #07264)
- Walgreen Co (Walgreens #07892)
- Walgreen Co (Walgreens #07611)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.