Individual provider Active NPI

Joel M Walsworth, DDS

  • Dentist
  • Waverly, IA
National Provider Identifier
1891860490
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8370 Issued in IA
Practice address
121 20TH St NW
Waverly, IA 50677
Phone
(319) 352-5281
Fax
(319) 352-0509
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8370 IA
Dentist 122300000X 8370 IA Primary

Addresses

Primary practice location

121 20TH St NW
Waverly, IA 50677

Mailing address

121 20TH St NW
Waverly, IA 50677
Phone (319) 352-5281

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
8370IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Walsworth Family Dentistry, P.C. General Practice CurrentSince Jul 24, 2022 Accepting new patients

Locations

121 20th St NW
Waverly, IA 50677
Phone (319) 352-5281

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891860490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 20TH ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "50677",
            "telephone_number": "319-352-5281",
            "fax_number": "319-352-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 20TH ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "50677",
            "telephone_number": "319-352-5281",
            "fax_number": "319-352-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSWORTH",
        "first_name": "JOEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8370",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "8370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.