Individual provider Active NPI

Monica Williams

  • Dentist
  • Atlanta, GA
National Provider Identifier
1063694719
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN013472 Issued in GA
Practice address
239 Ivan Allen Jr Blvd NW
Atlanta, GA 30313-1949
Phone
(404) 523-6571
Fax
(404) 523-6574
NPI assigned
Dec 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN013472 GA Primary
Dentist 122300000X 50 050784 NY

Addresses

Primary practice location

239 Ivan Allen Jr Blvd NW
Atlanta, GA 30313-1949

Mailing address

2009 Towaliga CT
Locust Grove, GA 30248-7404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160521000009 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214226810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50 050784NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1063694719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 TOWALIGA CT",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302487404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 IVAN ALLEN JR BLVD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303131949",
            "telephone_number": "404-523-6571",
            "fax_number": "404-523-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013472",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "50 050784",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.