NPIMap

Organization Active NPI

Williams Dental LLC

Doing business as Summit Dental

  • Dental Clinic/Center
  • Columbia, MO
National Provider Identifier
1295309854
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
WILLIAMS DENTAL LLC
Doing business as
Summit Dental
Practice address
2310 Forum Blvd Suite a
Columbia, MO 65203-5461
Phone
(573) 446-0032
Fax
(573) 447-4424
NPI assigned
May 18, 2021
Last updated
May 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Misty D Williams, DDSNPI 1194138362
Title
President
Phone
(573) 446-0032

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 NU Primary

Addresses

Primary practice location

2310 Forum Blvd Suite a
Columbia, MO 65203-5461

Mailing address

2310 Forum Blvd Apt a
Columbia, MO 65203-5461
Phone (573) 446-0032

Other names 1

  • Summit Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2310 Forum Blvd
Apt A
Columbia, MO 65203
Phone (573) 446-0032

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1295309854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 FORUM BLVD APT A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035461",
            "telephone_number": "573-446-0032",
            "fax_number": "573-447-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 FORUM BLVD SUITE A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035461",
            "telephone_number": "573-446-0032",
            "fax_number": "573-447-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-446-0032",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.