Michael Dale Williamson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3742979922 Issued in UT

Practice address

4735 S 2700 W
Salt Lake City, UT 84118-2123

Phone

(801) 966-4481

Fax

(801) 966-7306

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

Yes

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

Networks

• UT PPO D-SNP

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063533198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 S 2700 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841182123",
            "telephone_number": "801-966-4481",
            "fax_number": "801-966-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 S 2700 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841182123",
            "telephone_number": "801-966-4481",
            "fax_number": "801-966-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MICHAEL",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "3742979922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diantha Williamson, M.D.
• Jacob Paul Williamson, MD
• James M. Williamson, D.M.D
• Julie D. Williamson, MD
• Lindsay Taylor Williamson, OTR
• Richard Williamson
• Tina Marie Williamson
• Amber B Willis, PH.D., LMFT
• Cassius Musa Willis
• Connor Willis, PHARMD

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.