Individual provider Active NPI

Porchia Willis James, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Frisco, TX
National Provider Identifier
1568612893
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
10202 Issued in TN
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

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011001441 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4486942265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24219TXMDOral 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

Verify at the official NPI Registry.