David Wormhood, DDS
Individual provider Active NPI Dentist · Jamestown, CA
NPI 1962684597 · NPPES record last updated Dec 5, 2007
Key facts
- NPI
- 1962684597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 32519 (CA)
- Practice address
- 5100 Obyrnes Ferry Rd
Jamestown, CA 95327-9102 - Phone
- (209) 984-5291
- Fax
- (209) 984-4174
- NPI assigned
- Dec 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32519 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra Conservation Center | Past | Accepting new patients | |
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 32519 | CA | Yes |
Addresses
Primary practice location
5100 Obyrnes Ferry Rd
Jamestown, CA 95327-9102
Mailing address
5100 Obyrnes Ferry Rd
Jamestown, CA 95327-9102
Phone (209) 984-5291
Other providers in Jamestown, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.