Active NPI
Robert L Williamson, III, DDS3, PA
- Dentist
- Wilmington, NC
National Provider Identifier
1063584282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8999
- Legal business name
- ROBERT L WILLIAMSON, III, DDS3, PA
- Practice address
- 1624 Princess St
Wilmington, NC 28401-3848 - Phone
- (910) 251-8174
- Fax
- (910) 341-3037
- NPI assigned
- Nov 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nancy Campbell
- Title
- Regional Manager
- Phone
- (919) 624-7207
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7986 | NC | |
| Dentist | 122300000X | 8411 | NC | |
| Dentist | 122300000X | 8852 | NC | |
| Dentist | 122300000X | 8999 | NC | Primary |
| Dentist | 122300000X | 260100 | NC | |
| General Practice Dentistry | 1223G0001X | 7038 | NC |
Addresses
Primary practice location
1624 Princess St
Wilmington, NC 28401-3848
Mailing address
1624 Princess St
Wilmington, NC 28401-3848
Phone (910) 251-8174
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2058663 | Medicaid | NC | |
| 5901114 | Medicaid | NC | |
| 89902EJ | Medicaid | NC | |
| 5907981 | Medicaid | NC |
Other names 1
- Wilmington Comprehensive & Cosmetic Dentistry
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Wilmington, NC
- NPI 1144329046
-
- Dental Hygienist
- Wilmington, NC
- NPI 1497828610
-
- Dental Hygienist
- Wilmington, NC
- NPI 1871666131
-
- Dental Hygienist
- Wilmington, NC
- NPI 1427238450
-
- Dentist
- Wilmington, NC
- NPI 1568661155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1277942400000",
"number": "1063584282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1624 PRINCESS ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284013848",
"telephone_number": "910-251-8174",
"fax_number": "910-341-3037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1624 PRINCESS ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284013848",
"telephone_number": "910-251-8174",
"fax_number": "910-341-3037"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROBERT L WILLIAMSON, III, DDS3, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-14",
"last_updated": "2010-07-01",
"status": "A",
"authorized_official_last_name": "CAMPBELL",
"authorized_official_first_name": "NANCY",
"authorized_official_title_or_position": "REGIONAL MANAGER",
"authorized_official_telephone_number": "919-624-7207"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "NC",
"license": "7986",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "NC",
"license": "8411",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "NC",
"license": "8852",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "NC",
"license": "8999",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "NC",
"license": "260100",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "7038",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2058663",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5901114",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89902EJ",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5907981",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Wilmington Comprehensive & Cosmetic Dentistry",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.