Matthew Michael Willis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD10202 Issued in SC

Practice address

101 Morgan PL
Summerville, SC 29485-8106

Phone

(843) 851-2951

NPI assigned

Jun 8, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Family Dental Health of Oakbrook

  • General Practice Dentistry
  • Summerville, SC
  • NPI 1841938263
  NPD

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1043949779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MORGAN PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858106",
            "telephone_number": "843-851-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MORGAN PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858106",
            "telephone_number": "843-851-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MATTHEW",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD10202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Williams, COTA/L
• Patrice Denise Williams, RN, ADN
• Sharreka A Williams
• James Reed Williamson, D.M.D.
• Amber D Willis, MD
• Willturn PC
• Kathryn Diana Wilson-Horney, DPM
• Rachel L Wilson-Johnson
• Esther Spiegle Wilson, MD
• Lucretia D. Wilson, PMHNP-BC

• General Practice Dentistry in Summerville, SC
• Providers in Summerville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.