Individual provider Active NPI

David Mitchell Pond, DDS MDS

  • Periodontics
  • Kingsport, TN
National Provider Identifier
1710086418
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8499 Issued in TN
Practice address
210 Lockport CR
Kingsport, TN 37664
Phone
(423) 239-3993
Fax
(423) 239-9499
NPI assigned
Sep 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8499 TN Primary

Addresses

Primary practice location

210 Lockport CR
Kingsport, TN 37664

Mailing address

210 Lockport CR
Kingsport, TN 37664
Phone (423) 239-3993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20130710000274 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1153323712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David M Pond DDS MDS PC Periodontics Past Accepting new patients
Ronald F Godat DDS Ms PC Periodontics Past Accepting new patients

Organizations & group practices 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710086418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LOCKPORT CR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-239-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LOCKPORT CR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-239-3993",
            "fax_number": "423-239-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POND",
        "first_name": "DAVID",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "DDS MDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "8499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.