Tahira Williams, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN22424 Issued in FL

Practice address

5520 Pga Blvd Ste 208
Palm Beach Gardens, FL 33418-3981

Phone

(561) 776-6177

NPI assigned

Feb 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1477913093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240B N UNIVERSITY DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333224721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PGA BLVD STE 208",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183981",
            "telephone_number": "561-776-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TAHIRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100198300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlie Jerry Williams III
• Emily Williams
• Faith J Williams
• Kelsey Williams, M.S. CCC-SLP
• Kenyetta Williams, BT
• Tatyana Nicole Williams, DDS
• Toni Aaliyah Willie
• Blake James Willoughby II, DDS
• Ian Wilson, DC
• Michele Lee Wilson, LMHC, CAP

• General Practice Dentistry in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.