Active NPI
Gerald Alan Williams, DDS
- General Practice Dentistry
- Slidell, LA
National Provider Identifier
1114929262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- LA2386
- Practice address
- 2790 Gause Blvd E Ste 1
Slidell, LA 70461-4246 - Phone
- (985) 649-9359
- Fax
- (985) 649-9839
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | LA2386 | LA | Primary |
Addresses
Primary practice location
2790 Gause Blvd E Ste 1
Slidell, LA 70461-4246
Mailing address
109 Ondine LN
Slidell, LA 70458-9007
Phone (504) 453-9757
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LA2386 | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329955200000",
"number": "1114929262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 ONDINE LN",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704589007",
"telephone_number": "504-453-9757",
"fax_number": "985-847-9177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2790 GAUSE BLVD E STE 1",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704614246",
"telephone_number": "985-649-9359",
"fax_number": "985-649-9839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "GERALD",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2012-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "LA2386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.