DR. BRIAN DOUD WATKINS (NPI# 1124006226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124006226 |
Entity Type | Individual |
Full Name | DR. BRIAN DOUD WATKINS |
Credential | D.D.S. |
Practice Address |
10532 N Port Washington Rd Mequon WI 53092-5563 |
Mailing Address |
721 Fair Links Way Gurnee IL 60031-4706 |
Practice Telephone | 2622418300 |
Practice Fax Number | 2622418300 |
Mailing Telephone | 8473638354 |
Mailing Fax Number | 8379842104 |
Enumeration Date | 2006-01-09 |
Last Update Date | 2011-12-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223E0200X |
Dentist Specialization: Endodontics |
6421-15 | WI | Dental Providers |
N | 1223E0200X |
Dentist Specialization: Endodontics |
019-017476 | IL | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558343152 | Brian Patrick Watkins | Surgery | 1200 Driving Park Ave Ste 2, Newark, NY 14513-1090 | 2005-11-18 |
1922611292 | Brian Jeffrey Watkins | Pharmacist | 1587 N Courtenay Pkwy, Merritt Island, FL 32953-4454 | 2020-08-26 |
1801437082 | Brian Watkins | Student in an Organized Health Care Education/Training Program | 1300 N 17th Ave, Greeley, CO 80631-9584 | 2019-09-30 |
1457716276 | Brian Watkins | Counselor | 3050 White Plains Rd, Bronx, NY 10467-8124 | 2015-12-21 |
1710261045 | Brian M Watkins | Physical Therapy Assistant | 6300 67th St, Kenosha, WI 53142-1437 | 2011-10-05 |
Street Address |
10532 N PORT WASHINGTON RD |
City | MEQUON |
State | WI |
Zip Code | 53092-5563 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972598134 | Sally G Hunt | Pediatrics | 10532 N Port Washington Rd, Suite 1a, Mequon, WI 53092-5563 | 2005-09-14 |
1144797614 | Ovation Hand Institute, LLC | Family Medicine | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2018-11-01 |
1548713506 | Smart Choice Mri, LLC | Clinic/Center | 10532 N Port Washington Rd, Suite 1b, Mequon, WI 53092-5563 | 2016-07-26 |
1295100337 | Smart Choice Mri, LLC | Clinic/Center | 10532 N Port Washington Rd, Suite 1b, Mequon, WI 53092-5563 | 2015-12-01 |
1679984108 | Victoria Cassandra Jackson | Social Worker | 10532 N Port Washington Rd, Mequon, WI 53092 | 2014-05-19 |
1154742880 | Larry E Taylor | Psychologist | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2013-12-24 |
1366873598 | Peggy Nowicki | Counselor | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2013-12-13 |
1750711321 | Holly Kay Hallada | Counselor | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2013-11-19 |
1669712691 | Tiffany Ann Stark | Social Worker | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2013-02-28 |
1295012805 | Stefanie Carol Palmer | Counselor | 10532 N Port Washington Rd, Ste 1b, Mequon, WI 53092-5563 | 2011-11-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942790761 | Kathryn Mueller | Specialist/Technologist | 117 Linden Lane, Apt 7, Thiensville, WI 53092 | 2018-05-17 |
1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
1912437252 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 11430 Port Washington Road, Mequon, WI 53092 | 2017-06-19 |
1629437256 | Sean S Tsang | Acupuncturist | 909 W. Mequon Rd., Mequon, WI 53092 | 2016-02-10 |
1497128433 | Nancy Snoots | Counselor | 4430 W Tarrytown Ln, Mequon, WI 53092 | 2015-11-12 |
1609265214 | Evan Guettel | Physical Therapist | 11363 N. Port Washington Road, Mequon, WI 53092 | 2015-01-20 |
1881091148 | Sarah Krueger | Counselor | 216 N Green Bay Rd Suite 108, Thiensville, WI 53092 | 2014-12-01 |
1245667088 | Lora Transportation, LLC | Non-emergency Medical Transport (VAN) | 1228 West Baldwin Crt., Mequon, WI 53092 | 2013-10-10 |
1710314000 | Roxxi M Davis | Social Worker | 7113 Tamarack Ct, Mequon, WI 53092 | 2013-10-01 |
1225473713 | Forefront Dermatology, S.c. | Dermatology | 10303 N Port Washington Rd Ste 101, Mequon, WI 53092 | 2013-05-09 |
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Taxonomy Code | 1223E0200X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Endodontics |
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336287895 | Craig Renold Carr | Dentist | 10535 N Port Washington Rd, Mequon, WI 53092-5583 | 2007-02-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
1891319273 | Janesville Endodontics | Dentist | 1616 N Randall Ave Ste 180, Janesville, WI 53545-1155 | 2020-06-02 |
1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
1215344478 | Helen Tsao | Dentist | 2606 Stewart Ave, Ste 102, Wausau, WI 54401-5502 | 2014-07-18 |
1275973166 | Meridian Endodontics and Periodontics | Dentist | 20350 Water Tower Blvd Ste 203, Brookfield, WI 53045-3558 | 2013-06-25 |
1447698451 | Eva C Dahl | Dentist | 2700 National Dr Ste 1, Onalaska, WI 54650-6708 | 2013-06-12 |
1275873374 | F Kris Olsen | Dentist | 1320 S Green Bay Road, Racine Dental Group, Racine, WI 53406 | 2013-02-26 |
1063710655 | Erik Daniel Deyoung | Dentist | 6100 W State St, Apt. 636, Wauwatosa, WI 53213-2983 | 2011-03-05 |
1376786285 | Ronald David Meyers | Dentist | 2600 N Mayfair Rd Ste 240, Wauwatosa, WI 53226-1309 | 2009-04-08 |
1942450457 | Wisconsin Endodontic Group, S.c. | Dentist | 2600 N. Mayfair Rd., Ste 240, Wauwatosa, WI 53226 | 2008-09-22 |
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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.