NPIMap

Organization Active NPI

R. Glen Willis, DMD, PA

Doing business as Willis and Hook Dental Associates

  • General Practice Dentistry
  • Rock Hill, SC
National Provider Identifier
1063581270
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3242 Issued in SC
Legal business name
R. GLEN WILLIS, DMD, PA
Doing business as
Willis and Hook Dental Associates
Practice address
1144 India Hook Rd Ste F
Rock Hill, SC 29732-2400
Phone
(803) 327-4166
Fax
(803) 327-2086
NPI assigned
Nov 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ralph G Willis, DMDNPI 1700976727
Title
Dentist Owner
Phone
(803) 327-4166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3242 SC Primary

Addresses

Primary practice location

1144 India Hook Rd Ste F
Rock Hill, SC 29732-2400

Mailing address

1144 India Hook Rd Ste F
Rock Hill, SC 29732-2400
Phone (803) 327-4166

Other names 1

  • Willis and Hook Dental Associates Doing business as

National Provider Directory

National Provider Directory

Locations

1144 India Hook Rd
Ste F
Rock Hill, SC 29732
Phone (803) 327-4166

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063581270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 INDIA HOOK RD STE F",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322400",
            "telephone_number": "803-327-4166",
            "fax_number": "803-327-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 INDIA HOOK RD STE F",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322400",
            "telephone_number": "803-327-4166",
            "fax_number": "803-327-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. GLEN WILLIS, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "803-327-4166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willis and Hook Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.