Individual provider Active NPI

Mark G Williams, DDS

  • Prosthodontics
  • Anchorage, AK
National Provider Identifier
1467664524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
AA041 Issued in AK
Practice address
4450 Cordova St
Ste 130
Anchorage, AK 99503-7210
Phone
(907) 562-1686
Fax
(907) 563-6484
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X AA041 AK Primary

Addresses

Primary practice location

4450 Cordova St
Ste 130
Anchorage, AK 99503-7210

Mailing address

4450 Cordova St
Ste 130
Anchorage, AK 99503-7210
Phone (907) 562-1686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Sep 3, 2015 through Sep 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AA041AKMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467664524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 CORDOVA ST",
            "address_2": "STE 130",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037210",
            "telephone_number": "907-562-1686",
            "fax_number": "907-563-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 CORDOVA ST",
            "address_2": "STE 130",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995037210",
            "telephone_number": "907-562-1686",
            "fax_number": "907-563-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "G",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "AK",
            "license": "AA041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.