Active NPI
Edward J Williams, DMD
- General Practice Dentistry
- Lakeland, FL
National Provider Identifier
1477501120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN 10671
- Practice address
- 6958 Shimmering Dr
Lakeland, FL 33813-3331 - Phone
- (863) 646-2989
- Fax
- (863) 646-2890
- NPI assigned
- May 5, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN 10671 | FL | Primary |
Addresses
Primary practice location
6958 Shimmering Dr
Lakeland, FL 33813-3331
Mailing address
6958 Shimmering Dr
Lakeland, FL 33813-3331
Phone (863) 646-2989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 10671 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292198400000",
"number": "1477501120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6958 SHIMMERING DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338133331",
"telephone_number": "863-646-2989",
"fax_number": "863-646-2890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6958 SHIMMERING DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338133331",
"telephone_number": "863-646-2989",
"fax_number": "863-646-2890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "EDWARD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2010-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN 10671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.