Active NPI
William Francis Wathen, DMD
- Dentist
- Dallas, TX
National Provider Identifier
1982034427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9008
- Practice address
- 3302 Gaston Ave
Room 313
Dallas, TX 75246-2013 - Phone
- (214) 828-8267
- NPI assigned
- Nov 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9008 | TX | Primary |
Addresses
Primary practice location
3302 Gaston Ave
Room 313
Dallas, TX 75246-2013
Mailing address
2600 W 7TH St Apt 2540
Ft Worth, TX 76107-9310
Phone (817) 992-8364
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K0139964 | Other | TX | TEXAS DEPARTMENT OF PUBIC SAFETY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9008 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1982034427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 W 7TH ST APT 2540",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761079310",
"telephone_number": "817-992-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3302 GASTON AVE",
"address_2": "ROOM 313",
"city": "DALLAS",
"state": "TX",
"postal_code": "752462013",
"telephone_number": "214-828-8267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATHEN",
"first_name": "WILLIAM",
"middle_name": "FRANCIS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-20",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "9008",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS DEPARTMENT OF PUBIC SAFETY",
"identifier": "K0139964",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.