Individual provider Active NPI

Gregory Alan Williams, D.D.S.

  • Dentist
  • Quincy, WA
National Provider Identifier
1407003759
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60425350 Issued in WA
Practice address
746 F St SW
Quincy, WA 98848-1370
Phone
(509) 787-1507
Fax
(509) 787-2100
NPI assigned
Aug 19, 2008
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60425350 WA Primary

Addresses

Primary practice location

746 F St SW
Quincy, WA 98848-1370

Mailing address

14270 Manatee Circle
Magalia, CA 95954

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
60425350WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Y Kwon, DDS, PLLC CurrentSince Feb 24, 2022 Accepting new patients

Locations

746 F St SW
Quincy, WA 98848
Phone (509) 787-1507

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": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1407003759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14270 MANATEE CIRCLE",
            "city": "MAGALIA",
            "state": "CA",
            "postal_code": "95954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 F ST SW",
            "city": "QUINCY",
            "state": "WA",
            "postal_code": "988481370",
            "telephone_number": "509-787-1507",
            "fax_number": "509-787-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60425350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.