Individual provider Active NPI

Michael J Whitehouse, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Winston-Salem, NC
National Provider Identifier
1730109083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7036 Issued in NC
Practice address
3020 Maplewood Avenue
Winston-Salem, NC 27103-4012
Phone
(336) 768-9881
Fax
(336) 768-6066
NPI assigned
Jul 20, 2006
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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7036 NC Primary

Addresses

Primary practice location

3020 Maplewood Avenue
Winston-Salem, NC 27103-4012

Mailing address

125 Century Oaks
Winston-Salem, NC 27106
Phone (336) 922-9577

Other identifiers 1

IdentifierTypeStateIssuer
8990129MedicaidNC

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

LicenseStateTypeSpecialty
7036NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Walter & Ringeman, P.a. Oral and Maxillofacial Surgery PastSince Jan 1, 2014 Accepting new patients
James M. Walter, Jr, DDS, Ms, PA Oral and Maxillofacial Surgery 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730109083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CENTURY OAKS",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-922-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 MAPLEWOOD AVENUE",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271034012",
            "telephone_number": "336-768-9881",
            "fax_number": "336-768-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHOUSE",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "7036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990129",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

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.

Verify at the official NPI Registry.