Individual provider Active NPI

David Allan Williams, D.D.S.

  • General Practice Dentistry
  • Northbrook, IL
National Provider Identifier
1336178052
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
666 Dundee Rd
Suite 801
Northbrook, IL 60062-2727
Phone
(847) 291-0555
Fax
(847) 291-6933
NPI assigned
Jul 3, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

666 Dundee Rd
Suite 801
Northbrook, IL 60062-2727

Mailing address

666 Dundee Rd
Suite 801
Northbrook, IL 60062-2727
Phone (847) 291-0555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20160609002054 IL Order and Referring Only - DentistPractitioner - Dentist 6204126865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336178052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 801",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-291-0555",
            "fax_number": "847-291-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 801",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-291-0555",
            "fax_number": "847-291-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DAVID",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.