Individual provider Active NPI

David S Whitworth, DMD

  • General Practice Dentistry
  • Madison, AL
National Provider Identifier
1902015100
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3558 Issued in AL
Practice address
230 Hughes Rd
Suite a
Madison, AL 35758
Phone
(256) 772-9518
Fax
(256) 772-9993
NPI assigned
May 22, 2007
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
General Practice Dentistry 1223G0001X 3558 AL Primary

Addresses

Primary practice location

230 Hughes Rd
Suite a
Madison, AL 35758

Mailing address

230 Hughes Rd
Suite a
Madison, AL 35758
Phone (256) 772-9518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150731015426 AL Order and Referring Only - DentistPractitioner - Dentist 4284948449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3558ALMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902015100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HUGHES RD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35758",
            "telephone_number": "256-772-9518",
            "fax_number": "256-772-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HUGHES RD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "35758",
            "telephone_number": "256-772-9518",
            "fax_number": "256-772-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITWORTH",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.