Individual provider Active NPI

William Christian Bertram Desonne

  • Pediatric Dentistry
  • Mays Landing, NJ
National Provider Identifier
1386175149
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02779600 Issued in NJ
Practice address
2300 Wrangleboro Rd Ste 740
Mays Landing, NJ 08330-4419
Phone
(609) 829-3101
NPI assigned
Mar 23, 2017
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 22DI02779600 NJ Primary

Addresses

Primary practice location

2300 Wrangleboro Rd Ste 740
Mays Landing, NJ 08330-4419

Mailing address

1401 New Rd
Linwood, NJ 08221-1121
Phone (609) 829-3101

Other practice location 1

1401 New Rd
Linwood, NJ 08221-1121
Phone (609) 829-3101

Other practice location 2

501 White Horse Pike
West Collingswood, NJ 08107-1729
Phone (856) 854-1509

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

LicenseStateTypeSpecialty
22DI02779600NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Roundup Pediatric Dentistry LLC CurrentSince Oct 15, 2023 Accepting new patients

Locations

2300 Wrangleboro Rd
Ste 740
Mays Landing, NJ 08330
Phone (609) 829-3101

Organizations & group practices 1

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1386175149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 NEW RD",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211121",
            "telephone_number": "609-829-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 WRANGLEBORO RD STE 740",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083304419",
            "telephone_number": "609-829-3101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 New Rd",
            "address_purpose": "LOCATION",
            "city": "Linwood",
            "state": "NJ",
            "postal_code": "082211121",
            "country_code": "US",
            "telephone_number": "609-829-3101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 White Horse Pike",
            "address_purpose": "LOCATION",
            "city": "West Collingswood",
            "state": "NJ",
            "postal_code": "081071729",
            "country_code": "US",
            "telephone_number": "856-854-1509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESONNE",
        "first_name": "WILLIAM",
        "middle_name": "CHRISTIAN BERTRAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02779600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mays Landing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; 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.