Active NPI
Lauren Bruce Williams, DDS
- Dentist
- Salisbury, PA
National Provider Identifier
1467571240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS025121L
- Practice address
- 95 Grant Street
Salisbury, PA 15558 - Phone
- (814) 662-2737
- Fax
- (814) 662-2737
- NPI assigned
- Mar 29, 2007
- Last updated
- Jun 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS025121L | PA | Primary |
Addresses
Primary practice location
95 Grant Street
Salisbury, PA 15558
Mailing address
PO Box 460
107 Grant Street
Salisbury, PA 15558-0460
Phone (814) 662-2737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0010392060001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180712000758 | PA | Order and Referring Only - Dentist | 6709132376 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS025121L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466553600000",
"number": "1467571240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 460",
"address_2": "107 GRANT STREET",
"city": "SALISBURY",
"state": "PA",
"postal_code": "155580460",
"telephone_number": "814-662-2737",
"fax_number": "814-662-2738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 GRANT STREET",
"city": "SALISBURY",
"state": "PA",
"postal_code": "15558",
"telephone_number": "814-662-2737",
"fax_number": "814-662-2737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "LAUREN",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2016-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS025121L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0010392060001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.