Active NPI
William Carl Nielson, DDS
- Dentist
- Longwood, FL
National Provider Identifier
1336307248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN5275
- Practice address
- 1060 W State Rd 434
Ste 148
Longwood, FL 32750 - Phone
- (407) 332-8110
- Fax
- (407) 332-9245
- NPI assigned
- May 28, 2008
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN5275 | FL | Primary |
Addresses
Primary practice location
1060 W State Rd 434
Ste 148
Longwood, FL 32750
Mailing address
1060 W State Rd 434
Ste 148
Longwood, FL 32750
Phone (407) 332-8110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN5275 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1336307248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 W STATE RD 434",
"address_2": "STE 148",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "32750",
"telephone_number": "407-332-8110",
"fax_number": "407-332-9245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 W STATE RD 434",
"address_2": "STE 148",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "32750",
"telephone_number": "407-332-8110",
"fax_number": "407-332-9245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSON",
"first_name": "WILLIAM",
"middle_name": "CARL",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN5275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.