Otis Riley Washington Jr., D.D.S.,M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

5884 Issued in NC

Practice address

2310 Myron Dr
Raleigh, NC 27607-3358

Phone

(919) 782-9536

Fax

(919) 782-9962

NPI assigned

Jan 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770640732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 MYRON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073358",
            "telephone_number": "919-782-9536",
            "fax_number": "919-782-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 MYRON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073358",
            "telephone_number": "919-782-9536",
            "fax_number": "919-782-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "OTIS",
        "middle_name": "RILEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "5884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittaney Washington
• Ebony Washington
• Gail Francine Washington
• Malek Raymond Washington
• Melody Washington, MSW, LCSWA
• Sandra P Washington, PA
• Shakia M Washington
• Sheraton Noelle Washington
• Taylor Washington
• Yazmin T Washington

• Periodontics in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Periodontics in North Carolina

• 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.