Jacqueline Maxine Williams, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

DEN1001184 Issued in DC

Practice address

4 Atlantic St SW
Dental Office
Washington, DC 20032-2350

Phone

(202) 540-9857

Fax

(202) 540-9857

NPI assigned

Oct 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Dr. Jacqueline Maxine Williams Professional name

Medicare fee-for-service enrollment

Enrolled in DC

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.williams@coh.eclinicaldirectplus.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.

• Community of Hope, Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1649601154
  Medicare reassignment NPD
• Community of Hope Inc.

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1801548805
  NPD
• Community of Hope, Inc

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1881639714
  NPD

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1457651580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ATLANTIC ST SW",
            "address_2": "DENTAL OFFICE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322350",
            "telephone_number": "202-540-9857",
            "fax_number": "202-232-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ATLANTIC ST SW",
            "address_2": "DENTAL OFFICE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200322350",
            "telephone_number": "202-540-9857",
            "fax_number": "202-540-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACQUELINE",
        "middle_name": "MAXINE",
        "name_prefix": "Ms.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001184",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1001184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037409300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WILLIAMS",
            "middle_name": "MAXINE",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Irchibald Rimisa Williams
• Ishmael Williams
• Ishmale Williams
• Jacqueline Williams, HHA
• Jacqueline Williams
• James Kijuan Williams
• James T Williams, MD
• Janeashia Williams
• Janeisha Rena Williams
• Jasean Williams

• Dentist in Washington, DC
• Providers in Washington, DC by specialty
• Dentist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.