Organization Active NPI

Deborah M. Williams DDS

  • Dental Clinic/Center
  • West Memphis, AR
National Provider Identifier
1124621990
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DEBORAH M. WILLIAMS DDS
Doing business as
Deborah M. Williams
Practice address
300 W Tyler Ave
West Memphis, AR 72301-4225
Phone
(901) 413-6466
NPI assigned
Nov 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Deborah Williams, DDSNPI 1467443390
Title
President
Phone
(901) 413-6466

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

300 W Tyler Ave
West Memphis, AR 72301-4225

Mailing address

300 W Tyler Ave
West Memphis, AR 72301-4225
Phone (901) 413-6466

Other identifiers 1

IdentifierTypeStateIssuer
128654608MedicaidAR

Other names 1

  • Deborah M. Williams Doing business as

National Provider Directory

National Provider Directory

Locations

300 W Tyler Ave
West Memphis, AR 72301
Phone (870) 735-2540

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1124621990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W TYLER AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014225",
            "telephone_number": "901-413-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W TYLER AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014225",
            "telephone_number": "901-413-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH M. WILLIAMS DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-16",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-413-6466",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128654608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deborah M. Williams",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deborah M. Williams",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Memphis, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.