Individual provider Active NPI

Tiffany L Williams, D.D.S.

  • Student in an Organized Health Care Education/Training Program
  • Richmond, VA
National Provider Identifier
1558689240
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
521 N 11TH St RM 317
Dent: Pediatrics
Richmond, VA 23298-5045
Phone
(804) 828-1790
Fax
(804) 827-0163
NPI assigned
May 6, 2010
Last updated
Jul 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AC5385578-R614 NC
Student in an Organized Health Care Education/Training Program 390200000X VA Primary

Addresses

Primary practice location

521 N 11TH St RM 317
Dent: Pediatrics
Richmond, VA 23298-5045

Mailing address

PO Box 980566
Dent: Pediatrics
Richmond, VA 23298-0566
Phone (804) 828-1790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20251016001742 VA Order and Referring Only - DentistPractitioner - Dentist 8325535974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AC5385578-R614NCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1558689240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980566",
            "address_2": "DENT: PEDIATRICS",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980566",
            "telephone_number": "804-828-1790",
            "fax_number": "804-827-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N 11TH ST RM 317",
            "address_2": "DENT: PEDIATRICS",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985045",
            "telephone_number": "804-828-1790",
            "fax_number": "804-827-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "AC5385578-R614",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.