Active NPI
Porchia Willis James, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- Frisco, TX
National Provider Identifier
1568612893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 10202
- Practice address
- 12398 FM 423 Ste 200
Frisco, TX 75033-0157 - Phone
- (214) 705-1660
- NPI assigned
- Sep 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 24219 | TX | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 10202 | TN | Primary |
Addresses
Primary practice location
12398 FM 423 Ste 200
Frisco, TX 75033-0157
Mailing address
12398 FM 423 Ste 200
Frisco, TX 75033-0157
Phone (214) 705-1660
Other names 1
- Dr. Porchia Willis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161011001441 | TN | Order and Referring Only - Oral Surgery | 4486942265 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24219 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1568612893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12398 FM 423 STE 200",
"city": "FRISCO",
"state": "TX",
"postal_code": "750330157",
"telephone_number": "214-705-1660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12398 FM 423 STE 200",
"city": "FRISCO",
"state": "TX",
"postal_code": "750330157",
"telephone_number": "214-705-1660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "PORCHIA",
"middle_name": "WILLIS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-23",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TX",
"license": "24219",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TN",
"license": "10202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PORCHIA",
"last_name": "WILLIS",
"prefix": "DR.",
"credential": "D.D.S.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.