Individual provider Active NPI

Marion Williams

  • General Practice Dentistry
  • La Plata, MD
National Provider Identifier
1073960779
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16299 Issued in MD
Practice address
124 Rosewick Rd
La Plata, MD 20646-4251
Phone
(301) 934-4357
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16299 MD Primary

Addresses

Primary practice location

124 Rosewick Rd
La Plata, MD 20646-4251

Mailing address

304 Arlington Drive
Apartment B
La Plata, MD 20646
Phone (862) 224-6909

Other practice location 1

2041 Georgia Ave NW
Washington, DC 20059-0001
Phone (862) 224-6909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20231228002316 DC Order and Referring Only - DentistPractitioner - Dentist 2668763699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neibauer Dental Care, PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073960779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 ARLINGTON DRIVE",
            "address_2": "APARTMENT B",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "20646",
            "telephone_number": "862-224-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ROSEWICK RD",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206464251",
            "telephone_number": "301-934-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200590001",
            "country_code": "US",
            "telephone_number": "862-224-6909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Plata, MD

Sources for this page

Verify at the official NPI Registry.