Thomas Bradley Williams, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3808 Issued in SC

Practice address

118 Springhall Dr
Suite B
Goose Creek, SC 29445-5360

Phone

(843) 572-8009

Fax

(843) 377-0509

NPI assigned

Dec 19, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508929639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SPRINGHALL DR",
            "address_2": "SUITE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455360",
            "telephone_number": "843-572-8009",
            "fax_number": "843-377-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 SPRINGHALL DR",
            "address_2": "SUITE B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455360",
            "telephone_number": "843-572-8009",
            "fax_number": "843-377-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "THOMAS",
        "middle_name": "BRADLEY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3808",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID",
            "identifier": "1393195",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9634",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Buck Whitmire, RPH
• Renee Wicks, DR.
• Joni Wiggins, LPC, M.A.
• Jacqueline Williams
• Jasmine Renee Williams
• O'Stacia Williamson
• Janice Willis, RPH
• Cilantay R Wilson, APRN
• Jacob F Wilson, RBT
• Leonard Leon Wilson Jr., NP-C

• General Practice Dentistry in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.