Active NPI
William Wayne Gilliam, DDS
- General Practice Dentistry
- Lancaster, SC
National Provider Identifier
1205933223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2718
- Practice address
- 208 E Dunlap St
Lancaster, SC 29720-2511 - Phone
- (803) 286-5858
- Fax
- (803) 313-9650
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 2718 | SC | Primary |
Addresses
Primary practice location
208 E Dunlap St
Lancaster, SC 29720-2511
Mailing address
208 E Dunlap St
P.O. Box 1114
Lancaster, SC 29720-2511
Phone (803) 286-5858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 929811 | Medicaid | SC |
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 |
|---|---|---|---|
| 2718 | SC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gilliam Family Dentistry | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Lancaster, SC
- NPI 1952588824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1205933223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 E DUNLAP ST",
"address_2": "P.O. BOX 1114",
"city": "LANCASTER",
"state": "SC",
"postal_code": "297202511",
"telephone_number": "803-286-5858",
"fax_number": "803-313-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 E DUNLAP ST",
"city": "LANCASTER",
"state": "SC",
"postal_code": "297202511",
"telephone_number": "803-286-5858",
"fax_number": "803-313-9650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "WILLIAM",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "2718",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "929811",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.