Derrick Lynn Williamson, D.D.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

Practice address

1220 Hobson Rd
Suite 212
Naperville, IL 60540-8139

Phone

(630) 961-5850

NPI assigned

May 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427261569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HOBSON RD",
            "address_2": "SUITE 212",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408139",
            "telephone_number": "630-961-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 HOBSON RD",
            "address_2": "SUITE 212",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408139",
            "telephone_number": "630-961-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "DERRICK",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Nicholas Williams
• Janette Williams, PSYD, HSPP
• Kennedy Williams, LPC
• Paulette Williams, DBA
• Jeffrey Williamson-Link, M.D.
• Kimberly Williamson
• Rebecca Williamson, DO
• Sarah Elizabeth Williamson
• Anella Willis
• Elizabeth Marie Willis, MSW, LCSW

• Prosthodontics in Naperville, IL
• Providers in Naperville, IL by specialty
• Prosthodontics in Illinois

• 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.

Verify at the official NPI Registry.