NPIMap

Organization Active NPI

William L Whatley D.M.D. P.C.

  • Pediatric Dentistry
  • Saint Simons Island, GA
National Provider Identifier
1972663136
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10831 Issued in GA
Legal business name
WILLIAM L WHATLEY D.M.D. P.C.
Practice address
2487 Demere Rd
Suite 300
Saint Simons Island, GA 31522-5639
Phone
(912) 638-9302
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. William L Whatley Jr., D.M.D.NPI 1467510123
Title
President
Phone
(912) 638-9302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 10831 GA Primary

Addresses

Primary practice location

2487 Demere Rd
Suite 300
Saint Simons Island, GA 31522-5639

Mailing address

2487 Demere Rd
Suite 300
Saint Simons Island, GA 31522-5639
Phone (912) 638-9302

Other identifiers 1

IdentifierTypeStateIssuer
00458807AMedicaidGA

National Provider Directory

National Provider Directory

Locations

2487 Demere Rd
Ste 300
St Simons Island, GA 31522
Phone (912) 638-9302

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972663136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 DEMERE RD",
            "address_2": "SUITE 300",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225639",
            "telephone_number": "912-638-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2487 DEMERE RD",
            "address_2": "SUITE 300",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315225639",
            "telephone_number": "912-638-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM L WHATLEY D.M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHATLEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-638-9302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "10831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00458807A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Simons Island, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.