DR. DOUGLAS NORRIS WATERMAN (NPI# 1114243334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114243334 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS NORRIS WATERMAN |
| Credential | DDS |
| Practice Address |
4th & Inner Loop Road Bldg 171 Fort Irwin CA 92310 |
| Practice Telephone | 7195265537 |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2017-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DS8879 | TN | Dental Providers |
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
8879 | TN | Dental Providers |
| Street Address |
4TH & INNER LOOP ROAD BLDG 171 |
| City | FORT IRWIN |
| State | CA |
| Zip Code | 92310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710960620 | Jordan H.q. Tran | Dentist | 4th & Inner Loop Road, Building 171, Fort Irwin, CA 92310 | 2005-11-23 |
| 1922457027 | Michelle L Evans | Dental Assistant | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2016-06-09 |
| 1023467123 | Frances Marie Lee | Dental Assistant | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2016-06-09 |
| 1477902070 | Joshua Allen Hennis | Dental Assistant | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2016-06-06 |
| 1073999777 | Ryan Steven Payne | Dentist | 4th & Inner Loop Road, Bldg 171, Fort Irwin, CA 92310 | 2015-08-04 |
| 1649214248 | Douglas Neil Wade | Dentist | 4th & Inner Loop Road, Bldg. 171, Fort Irwin, CA 92310-5076 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100568 | Kellyann Michelle Francis | Dental Hygienist | 171, 4th St., Fort Irwin, CA 92310 | 2020-10-06 |
| 1598362253 | Lauren Elisabeth O'keefe | Dental Hygienist | 172 4th Street, Fort Irwin, CA 92310 | 2020-10-06 |
| 1215583737 | Lyra Angelica Velayo Matin | Marriage & Family Therapist | Bldg 390 N Loop Road, Fort Irwin, CA 92310 | 2019-08-12 |
| 1003384629 | Gary Barrow | Chiropractor | 390 Outerloop Rd, Fort Irwin, CA 92310 | 2018-11-13 |
| 1801373055 | Lee John Bizon Jr. | Nurse Practitioner | 390 North Loop Rd, Fort Irwin, CA 92310 | 2018-07-20 |
| 1619489937 | Ronda Marie Shiro | Dental Assistant | 171 Inner Loop Rpad, Fort Irwin, CA 92310 | 2017-10-26 |
| 1841713195 | James Degroot | Registered Nurse | Weed Army Community Hospital 390 North Loop Rd., Fort Irwin, CA 92310 | 2017-07-19 |
| 1356897615 | Alan Josiah Mills II | Dental Assistant | Bldg 171, 4th & Inner Loop Road, Fort Irwin, CA 92310 | 2016-08-28 |
| 1568917136 | Kathryn Paine | Physical Therapist | Building 390, North Loop Rd, Fort Irwin, CA 92310 | 2016-08-23 |
| 1487003588 | Kristyn Lauren Ollison | Dental Assistant | Bldg 248 A Meddac, Fort Irwin, CA 92310 | 2016-06-09 |
| Find all providers in zip 92310 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790888618 | Robert N Galbreath | Dentist | Bldg 478, 4th Street & G Avenue, Fort Irwin, CA 92310-5076 | 2006-09-06 |
| 1669457164 | Todd Shuji Kimura | Dentist | 4th & Interloop Road, Bldg 171, Us Army Dental Activity, Attn: Fran Gernert Credentials, Fort Irwin, CA 92311 | 2005-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1104425370 | Jack Bayraymyan Dental Group Inc. | Dentist | 2621 Zoe Ave Ste A, Huntington Park, CA 90255-4131 | 2020-10-20 |
| 1669071825 | Jack Bayraymyan Dental Group Inc. | Dentist | 418 E Glenoaks Blvd Ste 202, Glendale, CA 91207-2093 | 2020-10-20 |
| 1891394060 | Jack Bayraymyan Dental Group Inc. | Dentist | 600 S Alvarado St Ste 200-201, Los Angeles, CA 90057-3314 | 2020-10-20 |
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| 1396358453 | Bridget Powers | Dentist | 1000 Ygnacio Valley Rd, Walnut Creek, CA 94598-1812 | 2020-08-28 |
| 1144832221 | Manjeet Samra Dental Corporation | Dentist | 1700 Mchenry Ave Ste 16b, Modesto, CA 95350-4319 | 2020-08-19 |
| 1154932150 | Jacqueline Morgan Payne | Dentist | 1820 Sonoma Ave Ste 36, Santa Rosa, CA 95405-6617 | 2020-08-12 |
| 1922617802 | Andrew Levin | Dentist | 7891 Talbert Ave # 2, Huntington Beach, CA 92648-8612 | 2020-07-27 |
| 1861001885 | Robert Berger | Dentist | 2529 Via Sanchez, Palos Verdes Estates, CA 90274-2805 | 2020-07-26 |
| Find all providers with the same taxonomy | ||||
| City | FORT IRWIN |
| Zip Code | 92310 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.