DR. OTIS RILEY WASHINGTON JR. (NPI# 1770640732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770640732 |
| Entity Type | Individual |
| Full Name | DR. OTIS RILEY WASHINGTON JR. |
| Credential | D.D.S.,M.S. |
| Practice Address |
2310 Myron Dr Raleigh NC 27607-3358 |
| Practice Telephone | 9197829536 |
| Practice Fax Number | 9197829962 |
| Mailing Telephone | 9197829536 |
| Mailing Fax Number | 9197829962 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
5884 | NC | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801284005 | Otis Washington | Social Worker | 1602 Forest Ave Nw, Fort Payne, AL 35967-3324 | 2014-12-23 |
| Street Address |
2310 MYRON DR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-3358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851395727 | Thomas Edward Long | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2005-06-09 |
| 1255569745 | Benjamin William Brown | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2009-06-23 |
| 1861667537 | Thomas E. Long Dds II | Clinic/Center | 2310 Myron Dr, Suite 220, Raleigh, NC 27607-3358 | 2008-04-24 |
| 1558572289 | C Knox Mcmillan Dds, Ms, Pa | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2007-05-24 |
| 1114132651 | J. Christian Sheaffer Dds. Pllc | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2007-05-10 |
| 1659492155 | John Christian Sheaffer | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2007-04-02 |
| 1437286382 | Susan Douglas Gover | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2007-02-27 |
| 1053448902 | William David Gover | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2007-02-27 |
| 1326105966 | Gerald W Upton | Dentist | 2310 Myron Dr, Raleigh, NC 27607 | 2007-01-02 |
| 1457457038 | Gover & Gover, Dmd, Pa | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2006-09-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
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| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174030415 | Craig Dorion Dds Mph Pa IIi | Dentist | 2310 Myron Dr Ste 100, Raleigh, NC 27607-3358 | 2018-01-09 |
| 1801068184 | Sheppard A. Mckenzie Iv | Dentist | 7200 Stonehenge Dr Ste 104, Raleigh, NC 27613-1620 | 2008-03-27 |
| 1952594798 | Thiago Morelli | Dentist | 3200 Blue Ridge Rd Ste 122, Raleigh, NC 27612-8087 | 2007-08-24 |
| 1053525592 | Macon Michell Singletary | Dentist | 7805 Fiesta Way, Raleigh, NC 27615 | 2007-05-10 |
| 1124116918 | Steven W. Hamrick, Dmd, Pa | Dentist | 7501 Falls of Neuse Road, Suite 100, Raleigh, NC 27615 | 2006-10-10 |
| 1861899288 | Cataldo & Dorion Dds Pllc | Dentist | 202 W Millbrook Rd, Raleigh, NC 27609-4500 | 2014-12-01 |
| 1558572289 | C Knox Mcmillan Dds, Ms, Pa | Dentist | 2310 Myron Dr, Raleigh, NC 27607-3358 | 2007-05-24 |
| 1427171768 | Michael Craig Kretchmer | Dentist | 10931 Strickland Rd, Suite 101, Raleigh, NC 27615-2085 | 2007-04-10 |
| 1164592234 | David M. Simpson | Dentist | 7200 Stonehenge Dr, Suite 104, Raleigh, NC 27613-1620 | 2006-11-08 |
| 1700956851 | Steven W. Hamrick | Dentist | 7200 Stonehenge Dr, Suite 104, Raleigh, NC 27613-1620 | 2006-11-08 |
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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.