NPIMap

Organization Active NPI

Nicole Williams D.D.S., P.a.

  • Dentist
  • Goldsboro, NC
National Provider Identifier
1285780908
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7668 Issued in NC
Legal business name
NICOLE WILLIAMS D.D.S., P.A.
Practice address
1310 Wayne Memorial Dr Ste C
Goldsboro, NC 27534-2269
Phone
(919) 881-0909
Fax
(919) 881-0730
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nicole Kelley Williams, D.D.S.NPI 1336238690
Title
Owner
Phone
(919) 881-0909

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7668 NC Primary

Addresses

Primary practice location

1310 Wayne Memorial Dr Ste C
Goldsboro, NC 27534-2269

Mailing address

1310 Wayne Memorial Dr Ste C
Goldsboro, NC 27534-2269
Phone (919) 881-0909

Other identifiers 1

IdentifierTypeStateIssuer
5905716MedicaidNC

Other names 1

  • Goldsboro Dental Arts Doing business as

National Provider Directory

National Provider Directory

Locations

1310 Wayne Memorial Dr
Ste C
Goldsboro, NC 27534
Phone (919) 581-0909

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285780908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 WAYNE MEMORIAL DR STE C",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342269",
            "telephone_number": "919-881-0909",
            "fax_number": "919-881-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 WAYNE MEMORIAL DR STE C",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342269",
            "telephone_number": "919-881-0909",
            "fax_number": "919-881-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE WILLIAMS D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "KELLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-881-0909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "7668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905716",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goldsboro Dental Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.