Waterford Dental Specialists, PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

22583 Issued in TX

Legal business name

WATERFORD DENTAL SPECIALISTS, PLLC

Doing business as

Waterford Dental Specialists

Practice address

5246 S. 31St St.
Temple, TX 76502

Phone

(254) 773-4444

NPI assigned

Oct 31, 2008

Last updated

Oct 31, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Todd L Evans, DMDNPI 1033293568

Title

Owner

Phone

(254) 773-4444

Specialties & licenses 1

Addresses

Other names 1

• Waterford Dental Specialists Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Todd Larry Evans, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Temple, TX
  • NPI 1033293568
  Authorized official Same address or phone

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1912150111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 S. 31ST ST.",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "76502",
            "telephone_number": "254-773-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5246 S. 31ST ST.",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "76502",
            "telephone_number": "254-773-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFORD DENTAL SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-773-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "22583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterford Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelley Mia Warwick, MD
• Madeline Washburn-Rodriguez, DO
• Renika S Washington, LVN
• Kayla Washuta, DO
• Nathaniel Tabor Wasson, MD
• Waterford Oral Surgery
• Eugene Charles Waters, PHD
• Daniel Watkins, DO
• Heather Watkins, PA
• Samuel Watkins, PA

• Oral and Maxillofacial Surgery Clinic/Center in Temple, TX
• Providers in Temple, TX by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.