Active NPI
Scott A.D. Williams, D.D.S.
- Endodontics
- Yakima, WA
National Provider Identifier
1336232982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 4816
- Practice address
- 1020 S 40TH Ave
Suite F
Yakima, WA 98908-3800 - Phone
- (509) 965-7668
- Fax
- (509) 965-7520
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 4816 | WA | Primary |
Addresses
Primary practice location
1020 S 40TH Ave
Suite F
Yakima, WA 98908-3800
Mailing address
1020 S 40TH Ave
Suite F
Yakima, WA 98908-3800
Phone (509) 965-7668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180814003500 | WA | Order and Referring Only - Dentist | 0547519217 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4816 | WA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336232982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 S 40TH AVE",
"address_2": "SUITE F",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083800",
"telephone_number": "509-965-7668",
"fax_number": "509-965-7520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 S 40TH AVE",
"address_2": "SUITE F",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083800",
"telephone_number": "509-965-7668",
"fax_number": "509-965-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "SCOTT",
"middle_name": "A.D.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WA",
"license": "4816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- 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.