Colleen Williams DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

DD1870 Issued in NM

Legal business name

COLLEEN WILLIAMS DDS PC

Practice address

10409 Montgomery Pkwy NE Ste 202
Albuquerque, NM 87111-3862

Phone

(505) 881-8979

Fax

(505) 888-1003

NPI assigned

Nov 18, 2015

Last updated

Nov 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Meah M Washington, O.M.

Title

Office Manager

Phone

(505) 881-8979

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1144694878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10409 MONTGOMERY PKWY NE STE 202",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113862",
            "telephone_number": "505-881-8979",
            "fax_number": "505-888-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10409 MONTGOMERY PKWY NE STE 202",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113862",
            "telephone_number": "505-881-8979",
            "fax_number": "505-888-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEEN WILLIAMS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "MEAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-881-8979",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "O.M."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD1870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14750503",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.