Active NPI
Derek Williams, DDS
- Dentist
- Lufkin, TX
National Provider Identifier
1588016554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31939
- Practice address
- 701 S John Redditt Dr
Lufkin, TX 75904-3122 - Phone
- (936) 634-5012
- NPI assigned
- Jul 1, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 9831192-9921 | UT | |
| Dentist | 122300000X | 31939 | TX | Primary |
Addresses
Primary practice location
701 S John Redditt Dr
Lufkin, TX 75904-3122
Mailing address
2605 Hanks St
Lufkin, TX 75904-5477
Phone (801) 310-3658
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9831192-9921 | UT | MD | Dentist |
| 31939 | TX | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467331200000",
"number": "1588016554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2605 HANKS ST",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759045477",
"telephone_number": "801-310-3658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043122",
"telephone_number": "936-634-5012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DEREK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-01",
"last_updated": "2016-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "9831192-9921",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "31939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.