Active NPI
Ngobitak Williamson, DDS
- Pediatric Dentistry
- New York, NY
National Provider Identifier
1053932798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 062180
- Practice address
- 1824 Madison Ave
New York, NY 10035-3832 - Phone
- (212) 359-8660
- NPI assigned
- May 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 062180 | NY | Primary |
Addresses
Primary practice location
1824 Madison Ave
New York, NY 10035-3832
Mailing address
126 Washington St # 2
Malden, MA 02148-2556
Phone (781) 727-5969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 062180 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1053932798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 WASHINGTON ST # 2",
"city": "MALDEN",
"state": "MA",
"postal_code": "021482556",
"telephone_number": "781-727-5969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1824 MADISON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100353832",
"telephone_number": "212-359-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "NGOBITAK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-05",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "062180",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.