Active NPI
Dudley Martin Whitson, D.M.D.
- Dentist
- Dandridge, TN
National Provider Identifier
1720096126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS4714
- Practice address
- 1047 A South Hwy 92
Dandridge, TN 37725 - Phone
- (865) 397-2956
- Fax
- (865) 397-5589
- NPI assigned
- Aug 3, 2006
- Last updated
- Dec 31, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | DS4714 | TN | Primary |
Addresses
Primary practice location
1047 A South Hwy 92
Dandridge, TN 37725
Mailing address
PO Box 577
Dandridge, TN 37725-0577
Phone (865) 397-2956
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150717002392 | TN | Order and Referring Only - Oral Surgery | 9032422118 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS4714 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1720096126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 577",
"city": "DANDRIDGE",
"state": "TN",
"postal_code": "377250577",
"telephone_number": "865-397-2956",
"fax_number": "865-397-5589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1047 A SOUTH HWY 92",
"city": "DANDRIDGE",
"state": "TN",
"postal_code": "37725",
"telephone_number": "865-397-2956",
"fax_number": "865-397-5589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITSON",
"first_name": "DUDLEY",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2020-12-31",
"certification_date": "2020-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "DS4714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dandridge, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.