Individual provider Active NPI

Alfonza Hills Williamson Jr., DDS

  • Dentist
  • Winston Salem, NC
National Provider Identifier
1366712044
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9244 Issued in NC
Practice address
501 N Cleveland Ave
Winston Salem, NC 27101-4366
Phone
(336) 703-3090
Fax
(336) 631-2340
NPI assigned
Jan 11, 2012
Last updated
Jan 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9244 NC Primary

Addresses

Primary practice location

501 N Cleveland Ave
Winston Salem, NC 27101-4366

Mailing address

8420 Kinsale CT
Clemmons, NC 27012-8844
Phone (336) 767-4184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130611000042 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2567601222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9244NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alfonza H. Williamson Jr. DDS PLLC Current Accepting new patients
Forsyth County Public Health Cleveland Ave Dental Center Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1366712044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 KINSALE CT",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128844",
            "telephone_number": "336-767-4184",
            "fax_number": "336-767-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N CLEVELAND AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014366",
            "telephone_number": "336-703-3090",
            "fax_number": "336-631-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "ALFONZA",
        "middle_name": "HILLS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.