Michael Ray Williams, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20879 Issued in OH

Practice address

4579 Everhard Rd NW
Canton, OH 44718-2425

Phone

(330) 499-4353

Fax

(330) 499-7505

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265451116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 EVERHARD RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182425",
            "telephone_number": "330-499-4353",
            "fax_number": "330-499-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 EVERHARD RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182425",
            "telephone_number": "330-499-4353",
            "fax_number": "330-499-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "20879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2431578",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latosha Williams
• Layonna Williams
• Lekista Williams
• Marsha Hera Williams
• Marysa Rose Williams, PSY.D.
• Michael Scott Williams
• Monica Marie Williams
• Natalie Elaine Williams
• Patricia Williams, LCDC II
• Ruth Nicholson Williams, MA, CCC-SLP

• General Practice Dentistry in Canton, OH
• Providers in Canton, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.