Active NPI
David S Williams, DDS MSD
- Periodontics
- Albuquerque, NM
National Provider Identifier
1063430262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 1269
- Practice address
- 10409 Montgomery Pkwy NE
Suite 200
Albuquerque, NM 87111-3852 - Phone
- (505) 293-8310
- Fax
- (505) 293-8665
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1269 | NM | Primary |
Addresses
Primary practice location
10409 Montgomery Pkwy NE
Suite 200
Albuquerque, NM 87111-3852
Mailing address
10409 Montgomery Pkwy West NE
Suite 101
Albuquerque, NM 87111-0000
Phone (505) 293-8310
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 |
|---|---|---|---|
| 1269 | NM | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1063430262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10409 MONTGOMERY PKWY WEST NE",
"address_2": "SUITE 101",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871110000",
"telephone_number": "505-293-8310",
"fax_number": "505-293-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10409 MONTGOMERY PKWY NE",
"address_2": "SUITE 200",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871113852",
"telephone_number": "505-293-8310",
"fax_number": "505-293-8665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DAVID",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DDS MSD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NM",
"license": "1269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.