DR. DAMON OMAR WATSON (NPI# 1417155821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417155821 |
| Entity Type | Individual |
| Full Name | DR. DAMON OMAR WATSON |
| Credential | DDS, MD |
| Practice Address |
6031 Harbour Park Dr Midlothian VA 23112-2160 |
| Mailing Address |
11545 A Nuckols Road Glen Allen VA 23059-5666 |
| Practice Telephone | 8046083200 |
| Practice Fax Number | 8046083201 |
| Mailing Telephone | 8046738061 |
| Mailing Fax Number | 8046735644 |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2018-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
0401412132 | VA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2901018153 | MI | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 0438000245 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | DENTAL LICENSE NUMBER | 2901018153 | 01 |
| Street Address |
6031 HARBOUR PARK DR |
| City | MIDLOTHIAN |
| State | VA |
| Zip Code | 23112-2160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982170080 | Shonmarra Ylexus Glover | Behavior Technician | 5950 Harbour Lane, Midlothian, VA 23112 | 2018-10-17 |
| 1841778917 | Brett Stires | Behavior Technician | 5950 Harbourt Park Dr, Midlothian, VA 23112 | 2018-08-01 |
| 1538655899 | Surbhi Chandna | Dentist | 5921 Harbour Ln Ste 500, Midlothian, VA 23112 | 2018-07-10 |
| 1184121584 | Katie Marie Kashmer | Behavioral Analyst | 5950 Barbour Park Lane, Midlothian, WA 23112 | 2018-04-11 |
| 1497259832 | Ruth Lynn Kitchens | Occupational Therapist | 13900 Hull Street Rd., Midlothian, VA 23112 | 2018-03-21 |
| 1487157301 | Susan Stoodt Price | Occupational Therapist | Chesterfield Technical Center Hull, 13900 Hull Street Rd., Midlothian, VA 23112 | 2018-03-16 |
| 1922500495 | Rayna Veney Piper | Speech-Language Pathologist | 13900 Hull Street Road, Midlothian, VA 23112 | 2018-03-01 |
| 1891202883 | Rochelle Wallace | Behavioral Analyst | 5950 Harbourt Park Dr., Midlothian, VA 23112 | 2017-12-29 |
| 1184138448 | Virginia Medical & Therapeutic Services | Counselor | 13540 E Boundary Rd, Midlothian, VA 23112 | 2017-11-24 |
| 1386169118 | Brandon Poen | Physical Therapist | 2820 Waterford Lake Dr., Unit 013, Midlothian, VA 23112 | 2017-08-14 |
| Find all providers in zip 23112 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952356487 | Niamtu & Alexander Oral & Maxillofacial Surgery PC | Oral & Maxillofacial Surgery | 11319 Polo Pl, Midlothian, VA 23113 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450319 | Kipley Powell | Oral & Maxillofacial Surgery | Vcuhs Dept of Oral&maxillofacial Residency, 980566, 1250 E. Marshall Street, Richmond, VA 23298-0566 | 2020-06-04 |
| 1235499328 | Daniel Brett Bostock | Oral & Maxillofacial Surgery | 2843 Hartland Rd Ste 150, Falls Church, VA 22043-3543 | 2012-05-22 |
| 1003131731 | Philip J. Pandolfi, Dmd, Pllc | Oral & Maxillofacial Surgery | 2105 Evelyn Byrd Ave, Harrisonburg, VA 22801-5431 | 2010-04-06 |
| 1851424675 | James Hs Whitney Dds PC | Oral & Maxillofacial Surgery | 2071 Pro Pointe Ln., Harrisonburg, VA 22801 | 2007-03-13 |
| 1164591970 | Craig Ernest Vigliante | Oral & Maxillofacial Surgery | 19440 Golf Vista Plaza, Ste 130, Leesburg, VA 20176 | 2006-11-07 |
| 1679548010 | Gene Allen Vandervort Jr. | Oral & Maxillofacial Surgery | 44340 Premier Plaza, Suite 100, Ashburn, VA 20147-5074 | 2006-02-21 |
| 1437144789 | James H Priest | Oral & Maxillofacial Surgery | 420 Hamilton Blvd, South Boston, VA 24592-5200 | 2005-09-13 |
| 1831624618 | Christopher Loschiavo | Oral & Maxillofacial Surgery | 1250 E Marshall St, Box 980566, Richmond, VA 23298-5051 | 2017-04-28 |
| 1063711208 | Sarah Elizabeth Snow Summers | Oral & Maxillofacial Surgery | 244 Hydraulic Ridge Rd, Charlottesville, VA 22901-8124 | 2011-03-25 |
| 1588867113 | Viriginia Oral Facial & Implant Surgery | Oral & Maxillofacial Surgery | 7601 Lewinsville Rd, Suite 203, Mclean, VA 22102-2814 | 2007-06-10 |
| Find all providers with the same taxonomy | ||||
| City | MIDLOTHIAN |
| Zip Code | 23112 |
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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.