Williamsburg Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5965 Issued in NE

Legal business name

WILLIAMSBURG DENTAL LLC

Practice address

1265 S Cotner Blvd
Lincoln, NE 68510-4975

Phone

(402) 420-2222

NPI assigned

Dec 29, 2017

Organization subpart

Yes

Parent organization

WILLIAMSBURG DENTAL LLCAs reported in NPPES

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

Authorized official

Name

Bonnie L Gall

Title

Clinical Coordinator

Phone

(402) 904-6005

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Williamsburg Dental Piedmont Doing business as

Tax ID family

Williamsburg Dental LLC2 organizations share this tax ID, including this one

Part of

Williamsburg Dental LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Williamsburg Dental LLC

  • General Practice Dentistry
  • Lincoln, NE
  • NPI 1326226317
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Williamsburg Dental LLC

  • General Practice Dentistry
  • Lincoln, NE
  • NPI 1326226317
  NPPES parent name

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514505600000",
    "number": "1043727092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 L ST STE B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102456",
            "telephone_number": "402-904-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 S COTNER BLVD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104975",
            "telephone_number": "402-420-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAMSBURG DENTAL LLC",
        "enumeration_date": "2017-12-29",
        "last_updated": "2017-12-29",
        "status": "A",
        "authorized_official_last_name": "GALL",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL COORDINATOR",
        "authorized_official_telephone_number": "402-904-6005"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51070558700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williamsburg Dental Piedmont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Williams, PCMSW, PLMHP, PLADC
• Tynisha Charne' Williams
• Valerie K Williams, LMHP
• Yolanda Williams
• Williamsburg Behavioral Psychology, LLC
• Williamsburg Dental LLC
• Williamsburg Family Physicians P.C.
• Williamsburg Radiation Oncology PC
• Anne E Williamson, DDS MS
• Emily Williamson

• General Practice Dentistry in Lincoln, NE
• Providers in Lincoln, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.