Individual provider Active NPI

John Stuart Williams, D.D.S.

  • General Practice Dentistry
  • Sunnyvale, TX
National Provider Identifier
1023025608
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20559 Issued in TX
Practice address
272 S Collins Rd Ste 100
Sunnyvale, TX 75182-4643
Phone
(972) 216-1871
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20559 TX Primary
General Practice Dentistry 1223G0001X 7506 NC

Addresses

Primary practice location

272 S Collins Rd Ste 100
Sunnyvale, TX 75182-4643

Mailing address

1811 Greenville Ave Apt 1105
Dallas, TX 75206-7479
Phone (210) 214-0809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160301002651 NC Order and Referring Only - DentistPractitioner - Dentist 9931404894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7506NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyvale Smiles PastSince Oct 29, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1023025608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 GREENVILLE AVE APT 1105",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752067479",
            "telephone_number": "210-214-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 S COLLINS RD STE 100",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824643",
            "telephone_number": "972-216-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20559",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, TX

Sources for this page

Verify at the official NPI Registry.