Sheldon Willis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D6926 Issued in AZ

Practice address

1000 Lakeland Square Ext
Suite 700
Flowood, MS 39232-7620

Phone

(601) 933-0009

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• MS PPO C-SNP
• MS PPO D-SNP
• LA PPO C-SNP
• TN PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sheldon Willis, D.D.S., PLLC

  • General Practice Dentistry
  • Flowood, MS
  • NPI 1316106115
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214611200000",
    "number": "1013016104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LAKELAND SQUARE EXT",
            "address_2": "SUITE 700",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327620",
            "telephone_number": "601-933-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKELAND SQUARE EXT",
            "address_2": "SUITE 700",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327620",
            "telephone_number": "601-933-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SHELDON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3279-03",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D6926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04350504",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leeza Williams, MT
• Sandra Deloris Williams
• Susan Frichter Williams, M.D.
• Taaka Williams
• Nancy J. Williford, CFNP
• Wilson Therapeutic Touch LLC
• Clarence J Wilson
• Jaquelyn Michelle Wilson, PA-C
• Torris Terrell Wilson
• Gayle G Wimberly, LPC

• Dentist in Flowood, MS
• Providers in Flowood, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.