Mary E. Williard, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1151 Issued in AK

Practice address

1245 Fulton Ave
Coos Bay, OR 97420-2895

Phone

(541) 888-6433

NPI assigned

Feb 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.williard.p2@direct.coquilletribe.nextgenshare.com

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

• Confederated Tribes of Coos, Lower Umpqua & Siuslaw Indians

  dba Three Rivers Health Center - Florence

  • Federally Qualified Health Center (FQHC)
  • Florence, OR
  • NPI 1316788037
  NPD
• Confederated Tribes of Coos, Lower Umpqua & Siuslaw Indians

  dba Three Rivers Health Center - Coos Bay

  • Primary Care Clinic/Center
  • Coos Bay, OR
  • NPI 1780755454
  NPD
• Confederated Tribes of Coos, Lower Umpqua, & Siuslaw Indians

  dba Three Rivers Health Center - Dental

  • Dental Clinic/Center
  • Coos Bay, OR
  • NPI 1326889023
  NPD

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1437285798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 FULTON AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202895",
            "telephone_number": "541-888-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 FULTON AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202895",
            "telephone_number": "541-888-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIARD",
        "first_name": "MARY",
        "middle_name": "E.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11929",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD16151",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500797447",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Wilkins Jr., DPT
• Erica Wilkinson
• Bianca Williams, QMHA, PWS
• Stacy Williams
• Taylor Terrell Williams, MSW
• Leann Jean Willis Welch, NP
• Chris Alan Willson
• Anthony L Wilson, CRM
• James A Wilson, RPH
• Rebecca Maria Wilson, CPHT

• Dentist in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.